耳鸣患者焦虑及焦虑倾向的相关因素分析

Analysis of factors for anxiety and anxiety tendency in tinnitus patients

目的探讨耳鸣患者焦虑及焦虑倾向的相关因素。方法横断面研究。收集2020年1月至2023年12月复旦大学附属眼耳鼻喉科医院耳科门诊主诉耳鸣患者的基本资料、耳鸣特征及心理状态资料,所有患者填写焦虑自评量表(SAS),并进行纯音测听。根据耳鸣患者SAS评分将患者分为无焦虑组(SAS评分<40分),焦虑倾向组(SAS评分40~<50分)及焦虑组(SAS评分≥50分)。采用多因素有序logistic回归分析耳鸣患者焦虑及焦虑倾向的相关因素。结果共纳入176例患者,其中男57例,女119例,年龄13~76(49.4±10.7)岁,发病时间3 d~37年。其中无焦虑组78例(44.3%),焦虑倾向组65例(36.9%),焦虑组33例(18.8%);焦虑组病程[(43.4±15.1)个月]长于焦虑倾向组[(27.2±5.3)个月]和无焦虑组[(19.6±3.5)个月],差异均有统计学意义(均P<0.05);焦虑组[81.8%(27/33)]和焦虑倾向组[75.4%(47/65)]女性患者比例均高于无焦虑组[57.7%(45/78)],差异均有统计学意义(均P<0.05)。焦虑组患者伴有情绪失调[12.1%(4/33)比2.6%(2/78)]、压力[15.1%(5/33)比3.9%(3/78)]和睡眠障碍[48.5%(16/33)比23.1%(18/78)]的比例均高于无焦虑组,而焦虑倾向组仅有睡眠障碍[38.5%(25/65)比23.1%(18/78)]的比例高于无焦虑组(均P<0.05)。多因素有序logistic回归分析结果显示,睡眠障碍是耳鸣患者的焦虑及焦虑倾向的相关因素(OR=2.667,95%CI:1.451~4.909,P=0.002)。结论耳鸣患者中,存在焦虑和焦虑倾向的比例较高,睡眠障碍是耳鸣患者发生焦虑及焦虑倾向的相关因素。

Objective To explore the related factors of anxiety and anxiety tendency in patients with tinnitus.Methods A cross-sectional study was carried out.Basic information,tinnitus characteristics,and psychological status of patients who complained of tinnitus in the Outpatient Department of Eye&ENT Hospital,Fudan University between January 2020 and December 2023 were collected.All patients filled out the self-rating anxiety scale(SAS)and underwent pure tone audiometry testing.According to the SAS scores,patients were divided into three groups:non-anxiety group(SAS<40),anxiety tendency group(40≤SAS<50),and anxiety group(SAS≥50).The related factors of anxiety and anxiety tendency were analyzed using multivariate ordered logistic regression analysis.Results A total of 176 patients(57 males and 119 females)aged(49.4±10.7)years(range:13-76 years)were included,with the onset time of 3 days-37 years.There were 78 cases(44.3%),65 cases(36.9%)and 33 cases(18.8%)in the non-anxiety group,the anxiety tendency group and the anxiety group,respectively.The duration of disease in the anxiety group[(43.4±15.1)months]was significantly longer than that in the anxiety tendency group[(27.2±5.3)months]and the non-anxiety group[(19.6±3.5)months],with statistically significant differences(both P<0.05).The proportion of female patients in the anxiety group[81.8%(27/33)]and anxiety tendency group[75.4%(47/65)]was significantly higher than that in the non-anxiety group[57.7%(45/78)],and the differences were statistically significant(both P<0.05).The proportion of patients with emotional disorders[12.1%(4/33)vs 2.6%(2/78)],stress[15.1%(5/33)vs 3.9%(3/78)],and sleep disorders[48.5%(16/33)vs 23.1%(18/78)]in the anxiety group was significantly higher than that in the non-anxiety group(all P<0.05).The proportion of patients only had sleep disorders in the anxiety tendency group[38.5%(25/65)vs 23.1%(18/78)]was higher than that in the non-anxiety group,with a statistically significant difference(P<0.05).The results of multivariate ordered logistic regression analysis showed that sleep disorders werethe most significant factor affecting anxiety and anxiety tendency in tinnitus patients(OR=2.667,95%CI:1.451-4.909,P=0.002).Conclusion A significant proportion of tinnitus patients exhibit anxiety and anxiety tendency,and sleep disorders play a major role in the development of anxiety and anxiety tendencies in tinnitus patients.