200例主观性耳鸣患者听力损失临床分析

Study of hearing loss in 200 patients with subjective tinnitus

目的:对耳鸣患者的听力损失进行分析,为进一步探讨耳鸣的发病原因、检查方法提供临床依据。方法:对以主观性耳鸣为主诉的200例患者进行耳科专科检查、声导抗检测、常频纯音听阈测听和高频扩展听阈测听检查。结果:200例耳鸣患者中,单侧耳鸣123例(61.5%),双侧耳鸣77例(38.5%);46例(23.0%)听力正常。单侧耳鸣中,患侧与对侧听阈比较0.125～8kHz差异有统计学意义(P<0.05),10kHz及其以上频率差异无统计学意义(P>0.05)。常频听力正常组与听力异常组比较各频率阈值差异均具有统计学意义(均P<0.05),听力异常组扩展高频检出率低于听力正常组。结论:耳鸣可以存在听力正常的人群中,扩展高频测听能否为耳鸣患者提供早期听力损失的依据,尚需对更多的临床资料进一步研究。

Objective：To analyze the hearing loss profiles in patients with tinnitus,and then provide clinical foundation for further studying the etiology and examination methods of tinnitus.Method：Ear specialist examination,acoustic impedance test,normal frequency pure tone audiometry and extended high frequency audiometry were applied to 200 patients with chief complaint of subjective tinitus.Result：Among the 200 tinnitus cases,123（61.5%） patients were diagnosed with unilateral tinnitus,77（38.5%） patients with bilateral tinnitus and 46（23.0%） cases with normal hearing.In those patients with unilateral tinnitus,by comparing the hearing threshold of affected side and contralateral side（0.125-8 kHz）,the difference was statistically significant（P0.05）,but in extended high frequency（10 kHz）,the difference between two groups was not statistically significant（P0.05）.There was significant difference in hearing threshold between tinnitus patients with normal and abnormal hearing in normal frequency（P0.05）,meantime the detection rate in abnormal hearing group was lower than the normal group.Conclusion：Tinnitus can occur in people with normal hearing.Early in tinnitus,further study need be undertaken on whether the audiometry extended high frequency can offer the early evidence of hearing loss for tinnitus patients or not.