中华耳科学杂志
中華耳科學雜誌
중화이과학잡지
CHINESE JOURNAL OF OTOLOGY
2013年
2期
250-255
,共6页
李昕琚%梁勇%赵靖%刘友利%李衍菲%虞幼军%赵远新
李昕琚%樑勇%趙靖%劉友利%李衍菲%虞幼軍%趙遠新
리흔거%량용%조정%류우리%리연비%우유군%조원신
特发性耳鸣%听力损失%多因素分析
特髮性耳鳴%聽力損失%多因素分析
특발성이명%은력손실%다인소분석
Idiopathic tinnitus%hearing loss%Multivariate Analysis
目的探讨特发性耳鸣（Idiopathic Tinnitus）的心理声学及临床特征，寻找其之间的联系和规律，以指导临床治疗。方法对128例（159耳）特发性耳鸣患者进行系统的耳鼻咽喉科检查、听力学检查、耳鸣检查、问诊和耳鸣残疾度量表（tinnitus handicap inventory，THI）填写，将得到的性别、年龄、耳别、病程、耳鸣持续性、听力损失、听力曲线、耳鸣主调声频率和响度、最小掩蔽曲线、残余抑制试验和THI得分等12项指标量化分组，对耳鸣主调声频率、响度、最小掩蔽曲线、残余抑制试验和THI得分的影响因素进行Logistic回归分析。结果耳鸣主调声频率匹配高频占64.15%（102/159耳），低中频占35.85%（57/159耳）；耳鸣主调声响度匹配低响度占33.33%（53/159耳），中响度占42.14%（67/159耳），高响度占24.53%（39/159耳）；Feldmann曲线以汇聚型（20.13%，32/159耳）、重叠型（28.93%，46/159耳）和间距型（38.99%，62/159耳）为主；残余抑制试验结果中阳性占33.57%（47/140耳），部分阳性占42.14%（59/140耳），阴性占24.29%（34/140耳）；THI得分以轻微（42.14%，67/159耳）和轻度（35.22%，56/159耳）为主。Logistic回归分析示：耳鸣频率受性别(χ2=12.588，P＜0.001）和持续性（χ2=3.866，P=0.049）影响；耳鸣响度受听力损失程度（χ2=50.006，P＜0.001）、听力曲线类型（χ2=63.187，P＜0.001）和耳鸣主调声频率（χ2=14.757，P=0.001）影响；Feldmann曲线主要受到听力曲线类型影响（χ2=21.798，P=0.016）。χ2检验示：THI得分仅与残余抑制试验（χ2=16.284，P=0.012）相关；而残余抑制试验结果与性别等10项指标均不相关。结论特发性耳鸣临床指标间具有一定的相互联系：耳鸣主调声频率受到性别和耳鸣持续性影响，响度受频率及听力损失影响，而Feldmann曲线与听力曲线类型相关，后效抑制会影响THI得分。
目的探討特髮性耳鳴（Idiopathic Tinnitus）的心理聲學及臨床特徵，尋找其之間的聯繫和規律，以指導臨床治療。方法對128例（159耳）特髮性耳鳴患者進行繫統的耳鼻嚥喉科檢查、聽力學檢查、耳鳴檢查、問診和耳鳴殘疾度量錶（tinnitus handicap inventory，THI）填寫，將得到的性彆、年齡、耳彆、病程、耳鳴持續性、聽力損失、聽力麯線、耳鳴主調聲頻率和響度、最小掩蔽麯線、殘餘抑製試驗和THI得分等12項指標量化分組，對耳鳴主調聲頻率、響度、最小掩蔽麯線、殘餘抑製試驗和THI得分的影響因素進行Logistic迴歸分析。結果耳鳴主調聲頻率匹配高頻佔64.15%（102/159耳），低中頻佔35.85%（57/159耳）；耳鳴主調聲響度匹配低響度佔33.33%（53/159耳），中響度佔42.14%（67/159耳），高響度佔24.53%（39/159耳）；Feldmann麯線以彙聚型（20.13%，32/159耳）、重疊型（28.93%，46/159耳）和間距型（38.99%，62/159耳）為主；殘餘抑製試驗結果中暘性佔33.57%（47/140耳），部分暘性佔42.14%（59/140耳），陰性佔24.29%（34/140耳）；THI得分以輕微（42.14%，67/159耳）和輕度（35.22%，56/159耳）為主。Logistic迴歸分析示：耳鳴頻率受性彆(χ2=12.588，P＜0.001）和持續性（χ2=3.866，P=0.049）影響；耳鳴響度受聽力損失程度（χ2=50.006，P＜0.001）、聽力麯線類型（χ2=63.187，P＜0.001）和耳鳴主調聲頻率（χ2=14.757，P=0.001）影響；Feldmann麯線主要受到聽力麯線類型影響（χ2=21.798，P=0.016）。χ2檢驗示：THI得分僅與殘餘抑製試驗（χ2=16.284，P=0.012）相關；而殘餘抑製試驗結果與性彆等10項指標均不相關。結論特髮性耳鳴臨床指標間具有一定的相互聯繫：耳鳴主調聲頻率受到性彆和耳鳴持續性影響，響度受頻率及聽力損失影響，而Feldmann麯線與聽力麯線類型相關，後效抑製會影響THI得分。
목적탐토특발성이명（Idiopathic Tinnitus）적심리성학급림상특정，심조기지간적련계화규률，이지도림상치료。방법대128례（159이）특발성이명환자진행계통적이비인후과검사、은역학검사、이명검사、문진화이명잔질도량표（tinnitus handicap inventory，THI）전사，장득도적성별、년령、이별、병정、이명지속성、은력손실、은력곡선、이명주조성빈솔화향도、최소엄폐곡선、잔여억제시험화THI득분등12항지표양화분조，대이명주조성빈솔、향도、최소엄폐곡선、잔여억제시험화THI득분적영향인소진행Logistic회귀분석。결과이명주조성빈솔필배고빈점64.15%（102/159이），저중빈점35.85%（57/159이）；이명주조성향도필배저향도점33.33%（53/159이），중향도점42.14%（67/159이），고향도점24.53%（39/159이）；Feldmann곡선이회취형（20.13%，32/159이）、중첩형（28.93%，46/159이）화간거형（38.99%，62/159이）위주；잔여억제시험결과중양성점33.57%（47/140이），부분양성점42.14%（59/140이），음성점24.29%（34/140이）；THI득분이경미（42.14%，67/159이）화경도（35.22%，56/159이）위주。Logistic회귀분석시：이명빈솔수성별(χ2=12.588，P＜0.001）화지속성（χ2=3.866，P=0.049）영향；이명향도수은력손실정도（χ2=50.006，P＜0.001）、은력곡선류형（χ2=63.187，P＜0.001）화이명주조성빈솔（χ2=14.757，P=0.001）영향；Feldmann곡선주요수도은력곡선류형영향（χ2=21.798，P=0.016）。χ2검험시：THI득분부여잔여억제시험（χ2=16.284，P=0.012）상관；이잔여억제시험결과여성별등10항지표균불상관。결론특발성이명림상지표간구유일정적상호련계：이명주조성빈솔수도성별화이명지속성영향，향도수빈솔급은력손실영향，이Feldmann곡선여은력곡선류형상관，후효억제회영향THI득분。
Objective To study the psychoacoustic and clinical characteristics of idiopathic tinnitus and their correla-tions in order to improve clinic therapy for tinnitus. Method Systematic otorhinolaryngologic examination, audiometric test-ing, tinnitus evaluation were performed on 128 patients (159 ears) with idiopathic tinnitus. Tinnitus evaluation included tin-nitus pitch and loudness assessments and the Tinnitus Handicap Inventory (THI). Variables including gender, age, side of tinnitus, tinnitus duration and persistency, hearing loss, audiometric configuration, tinnitus pitch, loudness, Feldmann mask-ing curves, residual inhibition and THI score were quantified and their correlations analyzed by logistic regression models. Result Of the 159 ears, tinnitus was of high pitch in 102 ears (64.15%) and of mid or low pitch in 57 ears (35.85%), and its loudness was high in 53 ears (33.33%), moderate in 67 ears (42.14%) and soft in 39 ears (24.53%). Feldmann masking curves were dominated by convergent (32 ears, 20.13%), congruent (46 ears, 28.93%) and separate (62 ears, 38.99%) types. Residual inhibition was positive in 47 ears (33.57%), partially positive in 59 ears (42.14%) and negative in 34 ears (24.29%). THI scores indicated slight (67 ears, 42.14%) or mild (56 ears, 35.22%) tinnitus severity in most patients. Logis-tic regression showed correlation between tinnitus pitch and gender (χ2=12.588, P<0.001) and tinnitus persistency (χ2=3.866, P=0.049). Tinnitus loudness was correlated to hearing loss (χ2=50.006, P<0.001), audiometric configuration (χ2=63.187, P<0.001) and tinnitus pitch (χ2=14.757,P=0.001). Feldmann masking curve was chiefly influenced by audiomet-ric configuration (χ2=21.798, P=0.001). Theχ2 test showed that residual inhibition was correlated to THI scores (χ2=16.284, P=0.012), but not to the rest 10 items. Conclusion Certain psychoacoustic and clinical characteristics in idiopathic tinnitus appear to be correlated to each other. This information may help improve understanding of tinnitus and its treatment.
