A cross-sectional study and risk factors analysis of tinnitus in flight support personnel of PLA air force
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摘要: 目的 了解耳鸣在空军飞行保障人员中的流行特点，分析其听力学特征和相关危险因素。方法 采用横断面调查的方法，对空军两个场站飞行保障人员开展问卷调查和听力学检查，收集耳鸣的相关信息。结果 666名研究对象中，耳鸣发生率为24.2%，耳鸣残疾量表(THI)总分主要为1、2级; THI总分在各工作年限组存在差异，而耳鸣发生率在各听力状况组存在差异; 多因素logistic回归分析显示：自觉听力状况(OR=1.79)、交谈时要求对方重复话语频率(OR=1.64)、高频听力损失(HF-HL)分级(OR=1.39)是耳鸣的独立影响因素; 工作年限0~5年人群中耳鸣耳HF-HL、扩展高频听力损失(EHF-HL)发生率高于无耳鸣耳，而6~10年、>10年人群中耳鸣耳与无耳鸣耳EHF-HL发生率无差异; THI总分与SAS标准分存在中度相关性(r=0.759)，与PSQI总分存在弱相关性(r=0.445)。结论 高频听力损失、隐性听力损失者发生耳鸣的风险升高; 工作年限可影响耳鸣严重程度而不同频率听力状况仅影响耳鸣发生率; 随着年龄增加，噪声暴露在耳鸣的发生中作用逐渐下降。Abstract: Objective The aim of this study is to understand the epidemiological characteristics of tinnitus among flight support personnel and analyze its audiological characteristics and related risk factors.Methods The information of tinnitus was collected by a method of cross-sectional investigation using questionnaire survey and audiology test among the flight support personnel of two stations of PLA air force.Results The incidence of tinnitus among 666 subjects included was 24.2%, the THI grade was mainly grade 1 and grade 2. There were differences in THI scores among groups with different working years, but only differences in tinnitus incidence among groups with different frequency of hearing loss. Multivariate logistic regression analysis showed that grade of high frequency hearing loss(OR=1.39), conscious hearing loss(OR=1.79) and frequency of asking others to repeat words(OR=1.64) were independent risk factors of tinnitus. The incidence of HF-HL and EHF-HL in ears with tinnitus among 0-5 working years was higher than that without tinnitus, while the incidence of EHF-HL in ears with tinnitus was not different from that without tinnitus among 6-10 and >10 working years. There was moderate correlation between THI scores and SAS standard scores(r=0.759), and weak correlation between THI scores and PSQI scores(r=0.445).Conclusion The risk of tinnitus in high-frequency hearing loss and recessive hearing loss is increased; working years can affect the severity of tinnitus, while hearing conditions at different frequencies only affect the incidence of tinnitus; with increasing age, noise exposure plays a role in the occurrence of tinnitus decreasing gradually.
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Key words:
- tinnitus /
- hearing loss /
- risk factors
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表 1 耳鸣组与无耳鸣组基本情况对比
组别 年龄/岁 工作年限/年 BMI/(kg·m-2) SAS标准分 PSQI总分 耳鸣组 26(23~30) 7(3~11) 23.70±2.45 32(27~36) 7(5~9) 无耳鸣组 25(22~30) 6(2~10) 23.42±2.71 27(26~30) 5(3~7) 统计值 Z=-1.939 Z=-2.335 t=-1.227 Z=-7.187 Z=-8.065 P值 0.05 0.02 0.22 < 0.01 < 0.01 
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表 2 不同工作年限分组和听力状况分组间耳鸣发生率及THI总分对比
组别 例数 耳鸣人数(%) P值 THI总分/X±S P值 工作年限 0.08 < 0.01 0~5年组 311 68(21.9) 19.72±17.03 6~10年组 196 44(22.4) 18.23±12.41 >10年组 159 49(30.8) 29.84±25.25 听力状况 < 0.01 0.31 N-HL组 236 39(16.5) 19.41±16.84 HF-HL组 152 57(37.5) 24.84±18.95 EHF-HL组 412 115(27.9) 22.50±19.43
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表 3 耳鸣多因素logistic回归分析结果
变量 β值 OR(95%CI) P值 工作年限 0.028 1.03(0.81~1.31) 0.83 每天接触噪声时间 0.027 1.03(0.88~1.21) 0.74 自觉听力状况 0.582 1.79(1.30~2.48) < 0.01 交谈时要求对方重复话语频率 0.493 1.64(1.13~2.38) < 0.01 HF-HL分级 0.325 1.39(1.08~1.78) 0.01 EHF-HL分级 0.143 1.15(0.93~1.44) 0.20 常量 -4.055 < 0.01
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表 4 各工作年限组耳鸣耳与无耳鸣耳HF-HL、EHF-HL发生率对比
组别 总耳数 耳鸣耳数 发生HF-HL耳数 发生EHF-HL耳数 无耳鸣耳 耳鸣耳 P值 无耳鸣耳 耳鸣耳 P值 0~5年组 622 112(18.0) 49(9.6) 21(18.8) < 0.01 198(38.8) 59(52.7) < 0.01 6~10年组 392 70(17.9) 35(10.9) 16(22.9) < 0.01 173(53.7) 43(61.4) 0.24 >10年组 318 81(25.5) 68(28.7) 36(44.4) < 0.01 176(74.3) 58(71.6) 0.64
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