眼底动脉硬化与耳聋家族史交互作用对老年性耳聋影响

Effect of interaction between fundus atherosclerosis and family presbycusis history on presbycusis

目的探讨眼底动脉硬化与耳聋家族史交互作用对老年性耳聋的影响，为老年性耳聋进一步进行遗传学研究及发病机理研究提供可靠的理论依据。方法采用以医院为基础病例对照研究方法对2013年6月-2014年8月在哈尔滨市第九医院就诊的165例老年性耳聋患者和202例听力正常患者进行问卷调查以及眼底和听力检查。结果多因素logistic回归分析结果显示，调整年龄和性别后，眼底动脉硬化和耳聋家族史均存在时老年性耳聋发生的危险性是2项因素均不存在时的17．57倍（OR=17．57，95％C／=4．57—67．57）；调整年龄、性别、文化程度、职业、年人均收入、婚姻状况、吸烟、饮酒、高血压、糖尿病、冠心病、脑血管病等混杂因素后，眼底动脉硬化和耳聋家族史均存在时老年性耳聋发生的危险陛是2项因素均不存在时的10．69倍（OR=10．69，95％CI=2．71～42．28）；进一步进行交互作用分析结果显示，眼底动脉硬化与耳聋家族史对老年性耳聋未构成交互作用影响（OR=1．66，95％CI=0．25～10．94）。结论眼底动脉硬化与家族史均存在时增加了患老年性耳聋的风险，但二者无交互作用影响。

Objective To investigate the interactive effect of fundus atherosclerosis and family presbycusis history on the incidence of presbycusis and to provide a basis for the research of pathogenesis and genetics of elder deafness. Methods A based-hospital case-control study was carried out among 165 out-patients with presbycusis and 202 controls with normal hearing recruited in the Ear-Nose-Throat Department of Ninth Harbin Municipal Hospital between June 2013 through August 2014 with a questionnaire survey, fundus examination, and hearing test. Results The results of multivari- ate logistic regression showed that compared to those with neither fundus arteriosclerosis nor family presbycusis history, the participants with both fundus arteriosclerosis and family presbycusis history had a significantly higher risk of presbycusis, with the odds ratio （OR） of 17.57 （ 95 % confidence interval E 95 % CI ] ： 4. 57 - 67. 57 ） after adjusting for age and sex and the OR of 10. 69 （95% CI： 2. 71 - 42. 28） after adjusting for age, sex, smoking, alcohol consumption, education level, annual per capital income, hypertension, diabetes, coronary heart disease, and cerebrovascular disease; but no significant interactive effect of fundus arteriosclerosis and family presbycusis history on presbycusis was observed（ OR = 1.66 ; 95 % CI：O. 25 - 10. 94）. Conclusion The coexistence of fundus arteriosclerosis and family presbycusis history is significantly associated with an increased risk of presbycusis but the effect of the two factors is not interactive.