Effects of life events and emotional stress on short-term curative efficacy in adolescents with sudden hearing loss
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摘要: 目的 探讨高生活事件应激与情绪性应激对低频下降型突发性聋(LTSD)青少年近期疗效的影响。方法 对144例LTSD青少年患者治疗前的高生活事件应激、焦虑和抑郁情绪症状进行调查，并随访治疗3个月后LTSD患者的听力恢复情况，使用多因素logistic回归分析心理应激因素对LTSD患者预后的影响。结果 LTSD患者治疗后总有效103例，无效41例。无效组高生活事件应激、抑郁及焦虑情绪症状明显高于总有效组。将这3种心理应激因素同时纳入logistic多因素回归模型，在调整了治疗前听力损失程度和持续天数变量后发现高生活事件应激[OR(95%CI)=1.16(1.07~2.42)]及抑郁情绪[OR(95%CI)=1.65(1.26~2.71)]仍然显著影响青少年LTSD的预后。结论 生活应激与抑郁情绪可显著影响LTSD预后，心理应激管理可考虑作为青少年LTSD基本治疗的一部分。Abstract: Objective To investigate the effects of life events and emotional stress on short-term curative efficacy in adolescents with low-tone sudden deafness (LTSD).Method Various psychological stress measures were conducted on adolescent patients with recently diagnosed LTSD before initiating treatment, and the follow-up hearing condition were also obtained after 3 months of treatment. Using logistic regression analysis, we identified the predictors of life stress and emotion symptoms of treatment response in these adolescent patients.Result Treatment were effective in 103 cases and ineffective in 41 cases. The stress, depression and anxiety symptoms of the high-life events in the ineffective group were significantly higher than those in the effective group. The logistics regression analysis showed that life stress [OR(95%CI)=1.16(1.07-2.42)] and depressive symptoms [OR(95%CI)=1.65(1.26-2.71)] were significantly correlated with patients' prognosis after controlling for the duration of LTSD and the level of hearing loss before the treatment.Conclusion We found life stress and depressive symptoms were the independent predictors of treatment response in adolescent patients with LTSD. Our results also highlighted that psychological intervention may be part of the primary treatment for LTSD in adolescents.
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Key words:
- deafness, sudden /
- adolescent /
- life stress /
- depressive symptoms /
- anxiety symptoms
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表 1 LTSD患者治疗后总有效组与无效组临床及心理因素指标比较
例(%) 特征变量 总有效组
(n=103)无效组
(n=41)P 听力损失程度 轻度 30(29.1) 6(14.6) 0.022 中度 41(39.8) 7(17.1) 重度 22(21.4) 16(39.0) 极重度 10(9.7) 12(29.3) 持续时间/d 5.4±4.6 14.7±12.8 < 0.01 眩晕 是 81(78.6) 32(78.0) 0.597 否 22(21.4) 9(22.0) 耳鸣 是 59(57.3) 18(43.9) 0.176 否 44(42.7) 23(56.1) MLERQ得分 34.56±21.70 43.21±28.70 0.017 SCARED得分 19.73±3.75 24.06±6.02 0.009 CDI得分 18.17±3.89 21.82±4.67 0.007 正向CERQ得分 58.35±19.56 51.78±17.69 0.051 负向CERQ得分 32.94±8.14 37.33±10.70 0.028 
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表 2 高生活事件应激及情绪应激与青少年LTSD预后的多因素logistic回归分析
OR(95%CI) 模型1 模型2 模型3 模型4 高生活事件应激(MLERQ分≥28) 1.26(1.02~1.86)1) — — 1.16(1.07~2.42)1) 抑郁症状(ICD总分≥19) — 1.71(1.05~1.94)1) — 1.65(1.26~2.71)1) 焦虑症状(SCARED总分≥23) — — 1.17(1.01~1.96)1) 1.13(0.88~1.27) 持续天数 1.15(1.10~2.73)1) 1.14(1.11~2.94)1) 1.14(1.01~1.89)1) 1.12(1.10~2.53)1) 听力损失程度(轻度为参照组) 中度 1.35(0.83~5.76) 1.27(0.72~3.49) 1.16(0.65~2.51) 0.95(0.78~3.96) 重度 1.14(0.42~4.33)1) 1.26(0.83~3.73) 0.96(0.54~3.39) 1.07(0.54~4.00) 极重度 1.64(1.12~1.97)1) 1.91(1.25~1.78)1) 1.74(1.13~2.17)1) 1.83(1.25~1.99)1) 负向CERQ 1.14(1.01~1.89)1) 1.11(1.02~1.97)1) 1.09(1.01~2.13)1) 1.08(1.02~2.21)1) 1)P < 0.05。
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