CAJ | 학술논문

目的：评估老年性聋患者噪声下言语识别能力，探讨年龄、听力损失程度、认知功能对噪声下言语识别能力的影响。方法以90例60岁以上老年性聋者为受试者，按年龄分为三组，60～69岁（44例88耳）、70～79岁（32例64耳）、＞79岁（14例28耳），完成纯音听阈测试、普通话噪声下言语测试（Mandarin hearing in noise test ， MHINT）及简易智能精神状态量表（mini－mental state examination ，MMSE）评估，分别获得0．5、1、2、4 kHz平均听阈、MHINT自适应信噪比及MMSE量表总得分；分析年龄、平均听阈、自适应信噪比及MMSE量表得分之间的相关性。结果①平均听阈、M HINT信噪比随年龄增长而提高，不同年龄组间的平均听阈、M HINT 信噪比差异有统计学意义（P＜0．01）；②不同程度听力损失组间的M HINT信噪比差异显著（P＜0．01），控制认知得分的情况下其差异仍然有统计学意义（P＜0．01），且平均听阈与 MHINT 信噪比具有显著的直线相关性（r＝0．326，P＜0．01），随着受试者平均听阈提高，MMSE得分下降，二者有直线相关性（r＝－0．187，P＜0．05）；③MHINT信噪比与MMSE量表得分具有相关性（r＝－0．201，P＜0．01），认知功能减退组（＜27分）的MHINT信噪比平均值较认知功能正常组（27～30分）显著增加（P＜0．01）；不同听力损失程度组中，认知功能正常组与减退组之间M HINT信噪比差异无统计学意义（P＞0．05）。结论噪声下言语测试可用于老年人听觉功能评估，老年性聋者的年龄、听力损失程度、认知功能与噪声下言语识别能力之间相互影响，评估老年人听觉功能时应考虑认知功能的影响。
목적：평고노년성롱환자조성하언어식별능력，탐토년령、은력손실정도、인지공능대조성하언어식별능력적영향。방법이90례60세이상노년성롱자위수시자，안년령분위삼조，60～69세（44례88이）、70～79세（32례64이）、＞79세（14례28이），완성순음은역측시、보통화조성하언어측시（Mandarin hearing in noise test ， MHINT）급간역지능정신상태량표（mini－mental state examination ，MMSE）평고，분별획득0．5、1、2、4 kHz평균은역、MHINT자괄응신조비급MMSE량표총득분；분석년령、평균은역、자괄응신조비급MMSE량표득분지간적상관성。결과①평균은역、M HINT신조비수년령증장이제고，불동년령조간적평균은역、M HINT 신조비차이유통계학의의（P＜0．01）；②불동정도은력손실조간적M HINT신조비차이현저（P＜0．01），공제인지득분적정황하기차이잉연유통계학의의（P＜0．01），차평균은역여 MHINT 신조비구유현저적직선상관성（r＝0．326，P＜0．01），수착수시자평균은역제고，MMSE득분하강，이자유직선상관성（r＝－0．187，P＜0．05）；③MHINT신조비여MMSE량표득분구유상관성（r＝－0．201，P＜0．01），인지공능감퇴조（＜27분）적MHINT신조비평균치교인지공능정상조（27～30분）현저증가（P＜0．01）；불동은력손실정도조중，인지공능정상조여감퇴조지간M HINT신조비차이무통계학의의（P＞0．05）。결론조성하언어측시가용우노년인은각공능평고，노년성롱자적년령、은력손실정도、인지공능여조성하언어식별능력지간상호영향，평고노년인은각공능시응고필인지공능적영향。
Objective To evaluate the speech recognition ability in noise enviroment in older adults with age-related hearing loss and to discuss the influences of age ,hearing loss and cognitive function on the ability of speech recognition in noise enviroment .Methods A total of 90 older adults aged over 60 years at the hearing clinic of Xinhua hospital were divided into three groups according to the age ,which were 60~69 y group (88 ears) ,70~79 y group (64 ears) ,> 79 y group (28 ears) .All the participants completed pure tone audiometry ,the Mandarin hearing in noise test (MHINT) and the mini-mental state examination (MMSE) .The pure tone average hearing threshold (PTA) ,signal-to -noise ratio (SNR) of MHINT and MMSE scores were obtained .We used the statis_tical software SPSS 17 .0 to analyze the correlations among age ,PTA ,adaptive SNR and MMSE scores .ResuIts ①PTA and SNR increased with the age .The difference of PTA and SNR for different age groups was statistically sig_nificant (P<0 .01) .②The difference SNR among different PTA groups were significant (P<0 .01) ,and when the influence of MMSE scores was controlled the difference was still significant .There was a significant linear correlation between PTA and SNR (r=0 .326 ,P<0 .01) .MMSE scores decreased with the increasing of PTA ,and there was also a linear correlation between PTA and MMSE scores (-0 .187 ,P<0 .05) .③Adaptive SNR and MMSE scores were correlated (r= -0 .201 ,P<0 .01) ,but there was no significant linear relationship .Besides ,SNR of the cog_nitive function impairment group (<27 points) was significantly greater than that of the normal cognitive function group (27~30 points) (P<0 .01) .However ,among the three PTA groups ,the differences were not statistically significant .ConcIusion The hearing in noise test reflects the ability of speech recognition in noise enviroment in ol_der adults ,and can be used to assess the hearing functions in elder .Speech recognition in noise ,peripheral hearing loss and cognitive functions are relevant .Cognitive functions have an influence on the evaluation of the hearing func_tion for older adults .