老年体检人群听力筛查初探  

Preliminary study on hearing screening for the elderly population undergoing physical examinations

作　　者：左江兰 兰亚男 孙雯 乔宇斐 李婧 商莹莹 Zuo Jianglan;Lan Yanan;Sun Wen;Qiao Yufei;Li Jing;Shang Yingying(Department of Otorhinolaryngology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100730,China;Department of Health and Medicine,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100730,China)

机构地区：[1]中国医学科学院、北京协和医学院、北京协和医院耳鼻咽喉科,北京100730 [2]中国医学科学院、北京协和医学院、北京协和医院健康医学部,北京100730

出　　处：《中华耳鼻咽喉头颈外科杂志》2025年第2期166-171,共6页Chinese Journal of Otorhinolaryngology Head and Neck Surgery

基　　金：中央高水平医院临床科研专项(2022-PUMCH-B-095,2022-PUMCH-A-002)。

摘　　要：目的了解60岁及以上老年体检人群中听力损失的发病情况,探索纯音听阈测试用于老年人群听力筛查的可行性及适合我国国情的筛查标准。方法本研究为横断面研究,对2023年2—12月在北京协和医院体检中心进行体检的1066例老年人(男性619例,女性447例;年龄60~90岁,平均66.5岁)进行中文版老年听力障碍筛查量表(Chinese version Hearing Handicap Inventory for the Elderly Screening,CHHIE-S)筛查和纯音听阈测试。使用不同的筛查未通过标准计算老年人群中纯音听阈测试筛查未通过的比例,并比较其与CHHIE-S量表筛查结果的一致性,探讨合理的筛查标准。应用SPSS 27.0软件进行统计分析。结果该老年人群中18.39%(196/1066)存在中度及以上听力损失。使用固定强度策略单一频率不通过即判定为听力筛查未通过的筛查阳性率显著高于根据500、1000、2000、4000 Hz四个频率的平均听阈(4-frequency pure-tone average,4fPTA)高于临界值而得到的阳性率,差异有统计学意义(χ^(2)=136.56,P<0.001)。纯音听阈筛查较好耳4fPTA>35 dBHL与CHHIE-S量表得分>8分结果的一致性最好,Kappa值为0.554(P<0.001),阳性率为15.57%(166/1066)。结论在老年体检人群中进行基于纯音听阈测试的听力筛查是有效可行的方案。基于被筛查老年人群的主观感觉,纯音听阈测试双耳4fPTA均大于35 dBHL可能为听力筛查未通过的合理标准。ObjectiveTo understand the prevalence of hearing loss among individuals aged 60 and above undergoing physical examinations and to explore the feasibility of using pure tone audiometry(PTA)for hearing screening in the elderly population,as well as to establish screening criteria suitable for our country.MethodsThe study was a cross-sectional study,a total of 1066 elderly individuals(619 males and 447 females;Age range:60-90 years old,with an average of 66.5 years old)who underwent physical examinations at the Peking Union Medical College Hospital physical examination center from February to December 2023,were screened using PTA and the Chinese version Hearing Handicap Inventory for the Elderly Screening(CHHIE-S).Different screening criteria were applied to calculate the proportion of individuals who did not pass the PTA screening in the elderly population.The consistency between these results and the screening outcomes of the CHHIE-S scale was analyzed to explore reasonable screening standards.We performed statistical analysis using SPSS 27.0.ResultsIt was found that 18.39%of the elderly population had moderate or severe hearing loss.The positive rate determined by the detection of pure tones at a fixed dB level was significantly higher than that based on the average hearing threshold across 0.5,1,2,and 4 kHz frequencies(4-frequency pure-tone average,4fPTA),and the difference was statistically significant(χ^(2)=136.56,P<0.001).The criterion of 4fPTA>35 dB HL in the better ear showed the highest consistency with the criterion of CHHIE-S>8,with a Kappa value of 0.554(P<0.001),and this criterion resulted in a positive rate of 15.57%(166/1066).ConclusionsConducting hearing screening based on PTA among the elderly population undergoing physical examinations is an effective and feasible approach.Given the subjective perceptions of the elderly population being screened,a 4fPTA greater than 35 dB HL in both ears might be a reasonable criterion.

关 键 词：老年性聋 老年人 听力检查 测听法 纯音 

分 类 号：R764.04[医药卫生—耳鼻咽喉科]