特发性耳鸣患者心理声学及临床特征研究

汪维庆; 杨见明

doi:10.13201/j.issn.1001-1781.2018.21.011

特发性耳鸣患者心理声学及临床特征研究

汪维庆,
杨见明^,

- 安徽医科大学第二附属医院耳鼻咽喉头颈外科(合肥, 230000)

详细信息

通讯作者: 杨见明, E-mail:Jmyang@163.com

中图分类号: R764.45

收稿日期: 2018-09-12

Psychoacoustic and clinical features of patients with idiopathic tinnitus

WANG Weiqing,
YANG Jianming^,

- Department of Otorhinolaryngology Head and Neck Surgery, the Second Affiliated Hospital of Anhui Medical University, Hefei, 230000, China

More Information

Corresponding author: YANG Jianming, E-mail: Jmyang@163.com

Received Date: 12 September 2018

摘要

摘要: 目的: 探讨特发性耳鸣患者的心理声学及临床特征,了解耳鸣频率、响度与听力损失之间的联系和规律,为耳鸣的个性化诊治提供依据。方法: 对110例特发性耳鸣患者进行系统的耳科专业检查、听力学检查、耳鸣精细化检查、病史询问和耳鸣残疾度量表(THI)调查。结果: 患者年龄以20~60岁最多(95.45%),20岁以下及60岁以上者明显减少;耳鸣位点频率与听力损失最大频率完全一致的共有67例(60.9%),Pearson相关性分析得出二者具有相关性(r=0.989,P<0.05);耳鸣响度匹配结果大多集中在40~60dBSL(37.3%),Pearson相关性分析得出其与听损程度存在相关性(r=0.932,P<0.05)。该研究采用多元复合声治疗耳鸣,总体有效率达67.3%,患者残余抑制试验的结果与多元复合声治疗效果的评价分级存在显著相关性(r=0.438,P<0.05);残余抑制试验结果部分阳性和阳性、阴性组的THI分数差异有统计学意义(r=-2.464,P<0.05)。THI和病程之间无相关性(r=-0.047,P>0.05)。结论: 患者的耳鸣频率和响度与听力损失程度之间存在一定相关性;残余抑制试验的结果可以提示患者声治疗的有效性且可以影响患者的THI得分。耳鸣精细化检查可以为耳鸣患者早期听力损失的检出提供临床参考依据。
- 特发性耳鸣 /
- 听力损失 /
- 相关性
Abstract: Objective: The aim of this study is to explore the psychoacoustic and clinical features of patients with idiopathic tinnitus, to understand the relationship and regularity between tinnitus frequency, loudness and hearing loss, and to provide a basis for personalized diagnosis and treatment of tinnitus.Method: A total of 110 patients with idiopathic tinnitus underwent systematic otological professional examination, audiological examination, tinnitus refinement examination, medical history inquiry and tinnitus disability scale (THI) survey.Result: Tinnitus more frequently occurred between 20 to 60 years of age(95.45%), a significant decrease in people under the age of 20 and over the age of 60; 67 cases(60.9%) of the tinnitus frequency were completely consistent with the maximum frequency of hearing loss, The Pearson test showed that tinnitus frequency was correlated to frequency of hearing loss (r=0.989,P<0.05). Tinnitus loudness pitch results are mostly concentrated between 40-60 dBSL, The Pearson test showed that tinnitus loudness was correlated to hearing loss(r=0.932,P<0.05); The total effective rate of sound therapy was 67.3%, There was a correlation between Residual inhibition and sound therapy(r=0.438, P<0.05); No statistic difference was found between THI scores and Tinnitus duration (r=-0.047,P>0.05).Conclusion: There was a correlation between tinnitus pitch and hearing loss.Residual inhibition may indicate the effectiveness of the sound therapy and may affect the patient's THI score. Full Precision Test can provide clinical reference for early detection of hearing loss in tinnitus patients.
- idiopathic tinnitus /
- hearing loss /
- correlation

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参考文献(21)

[1]	李辉, 李明, 张剑宁.特发性耳鸣患者心理声学特征的临床价值研究[J].临床耳鼻咽喉头颈外科杂志, 2018, 32 (8):570-575.
[2]	贺璐, 王国鹏, 彭哲, 等.耳鸣临床应用指南[J].听力学及言语疾病杂志, 2015, 23 (2):116-139.
[3]	中华耳鼻咽喉头颈外科杂志编辑委员会耳科专业组.2012耳鸣专家共识及解读[J].中华耳鼻咽喉头颈外科杂志, 2012, 47 (9):709-711.
[4]	陈知己, 郑芸, 钟萍, 等.耳鸣评价量表的临床应用价值研究[J].听力学及言语疾病杂志, 2017, 25 (3):242-246.
[5]	李昕琚, 梁勇, 赵靖, 等.特发性耳鸣心理声学及临床特征的多因素分析[J].中华耳科学杂志, 2013, 11 (2):250-255.
[6]	全国声学标准化技术委员会.声学纯音气导听阈测定.听力保护用GB7583-87[M].北京:中国标准出版社, 1987:84-85.
[7]	JASTREBOFF P J, JASTREBOFF M M.Tinnitus retraining therapy (TRT) as a method for treatment of tinnitus and hyperacusis patients[J].J Am Acad Audiol, 2000, 11:162-170.
[8]	刘蓬.耳鸣程度分级与疗效评定标准的探讨[J].中国中西医结合耳鼻咽喉科杂志, 2004 (4):181-183.
[9]	黄治物, 吴皓.耳鸣中枢化机制与临床诊疗[J].临床耳鼻咽喉头颈外科杂志, 2014, 28 (4):222-225.
[10]	罗彬, 熊彬彬, 孙伟, 等.个性化多元复合声对慢性主观性耳鸣临床疗效的初步分析[J].临床耳鼻咽喉头颈外科杂志, 2018, 32 (11):819-822.
[11]	SAUNDERS J C.The role of central nervous system plasticity in tinnitus[J]Commun Disord, 2007, 40:313-334.
[12]	MAHLKE C, WALLHAUSSER-FRANKE E.Evidence for tinnitus-related plasticity in the auditory and limbic system, demonstrated by arg 3.1and c-fos immunocytochemistry[J].Hear Res, 2004, 195:1-2.
[13]	余力生, 马鑫.耳鸣的诊治思路探讨[J].临床耳鼻咽喉头颈外科杂志, 2018, 32 (8):563-565.
[14]	杨东, 周慧芳.耳鸣的发病率与病因分析[J].中国医药科学, 2014, 4 (1):39-42.
[15]	SEYDEL C, HAUPT H, OLZE H, et al.Gender and chronic tinnitus:differences in tinnitus-related distress depend on age and duration of tinnitus[J].Ear Hear, 2013, 34:661-672.
[16]	曹祖威, 岳凤娟, 刘蓬, 等.164例不同类型听力曲线耳鸣患者疗效差异分析[J].临床耳鼻咽喉头颈外科杂志, 2018, 32 (13):1020-1022.
[17]	陈平, 苏纪平, 蔡红武, 等.82例耳鸣患者半倍频程频率纯音测听的特征及意义[J].临床耳鼻咽喉科杂志, 2004, 18 (10):593-595.
[18]	ANDERSSON G.Tinnitus loudness matchings in relation to annoyance and grading of severity[J].Auris Nasus Larynx, 2003, 30:129-33.
[19]	JASTREBOFF P J.25years of tinnitus retraining therapy[J].HNO, 2015, 63:307-311.
[20]	ERLANDSSON S I, HALLBERG L R.Prediction of quality of life in patients with tinnitus[J].Br J Audiol, 2000, 34:11-20.
[21]	JATREBOFF P J, GRAY W C, GOLD S M.Neurophysological approach to tinnitus patients[J].Am JOtol, 1998, 17:226-230.