急性耳鸣临床特征和严重程度的影响因素分析  

Analysis of the Influencing Factors of Clinical Characteristics and Severity of Acute Tinnitus

作　　者：惠林娜 宋勇莉 齐柳 杨花荣[3] 李瑞[1,2] 潘洋洋[1] 查定军 Hui Linna;Song Yongli;Qi Liu;Yang Huarong;Li Rui;Pan Yangyang;Zha Dingjun(Department of Otorhinolaryngology-Head and Neck Surgery Xijing Hospital,PLA Air Force Military University,Xi'an,710032,China;Medical School of Yan'an University;不详)

机构地区：[1]中国人民解放军空军军医大学西京医院耳鼻咽喉头颈外科,西安710032 [2]延安大学医学院 [3]延安大学附属医院

出　　处：《听力学及言语疾病杂志》2024年第5期426-431,共6页Journal of Audiology and Speech Pathology

基　　金：陕西省科技重点项目资助(2021LCZX-15)。

摘　　要：目的分析急性耳鸣患者的临床特征和影响耳鸣严重程度的相关因素。方法回顾性分析319例急性耳鸣患者的基本资料、耳鸣发生部位、病程、耳鸣声学特征、听力下降、合并头痛、头晕、耳闷、耳痛等症状及伴发临床疾病等;均完成耳鸣障碍量表(tinnitus handicap inventory,THI)、广泛性焦虑障碍量表(generalized anxiety disorder,GAD-7)、抑郁筛查量表(patient health questionnaire,PHQ-9)、匹兹堡睡眠质量指数量表(Pittsburgh sleep scale,PSQI)、听觉过敏调查表(hyperacusis questionnaire,HQ)、D型人格量表(type D personality scale-14,DS-14)等评估,THI评分≤36分判定为轻度耳鸣组,38~56分为中度耳鸣组,58~100分为重度-极重度耳鸣组。以THI分组作为应变量,上述各因素作为自变量,采用有序多分类logistic回归分析各因素与急性耳鸣严重程度的相关性。结果319例急性耳鸣患者中轻度耳鸣组158例(49.5%),中度耳鸣组72例(22.6%),重-极重度耳鸣组89例(27.9%)。有序多分类logistic回归分析发现听觉过敏(OR=3.921)、焦虑(OR=2.495)、抑郁(OR=2.921)、D型人格(OR=0.349)与急性耳鸣严重程度有关(P<0.05),伴听觉过敏、焦虑、抑郁、D型人格者耳鸣严重程度更重。结论听觉过敏、焦虑、抑郁、D型人格可能是影响急性耳鸣严重程度的因素,在治疗急性耳鸣患者时应予高度关注。Objective To study the clinical characteristics and related factors affecting the severity of acute tinnitus in patients.Methods A retrospective analysis was conducted on the data of 319 patients with acute tinnitus.All patients had detailed case history,including basic patient information,tinnitus location,course of disease,acoustic characteristics of tinnitus,hearing loss,combined headache,dizziness,aural fallness,earache and other symptoms,as well as accompanying clinical diseases.All patients completed the tinnitus handicap inventory(THI),generalized anxiety disorder(GAD-7),patient health questionnaire(PHQ-9),pittsburgh sleep quality index(PSQI),hyperacusis questionnaire(HQ),type D personality scale-14(DS-14),etc.The mild tinnitus group was determined based on a THI score of≤36.The moderate tinnitus group was determined based on a THI score of 38~56.The severe to extremely severe tinnitus group was determinded based on THI 56~100.THI grouping was used as the dependent variable and the above factors as independent variables.The correlation between each factor and the severity of acute tinnitus was analyzed using ordered multinomial logistic regression.Results Among 319 patients with acute tinnitus,158(49.5%)were in the mild tinnitus group,and 72(22.6%)were in the moderate tinnitus group,and 89(27.9%)were in severe to extremely severe tinnitus group.Ordered multinomial logistic regression analysis found that hyperacusis(OR=3.921),anxiety(OR=2.495),depression(OR=2.921),and D-type personality(OR=0.349)were associated with the severity of acute tinnitus(P<0.05),with more serere tinnitus in these patients.Conclusion Hyperacusis,anxiety,depression,and D-type personality may be factors that affect the severity of acute tinnitus,so high attention should be paid when treating patients with acute tinnitus.

关 键 词：急性耳鸣 听觉过敏 焦虑 抑郁 睡眠障碍 

分 类 号：R764.45[医药卫生—耳鼻咽喉科]