可接受噪声级与噪声下言语测试在老年性聋助听器验配效果评估中的应用

Mandarin acceptable noise level test and mandarin hearing in noise test in outcome assessment of hearing aid fitting for presbycusis

目的研究普通话版可接受噪声级(Mandarin acceptable noise level,M-ANL)测试及普通话版噪声下听力测试(Mandarin hearing in noise test,MHINT)在老年性聋助听器验配效果评估中的作用。方法对20名中度至中-重度的老年性聋助听器验配的患者进行助听后的M-ANL及MHINT测试;采用Na-belek的国际分级标准,根据受试者的M-ANL值将其分为M-ANL值<7d B组和M-ANL值≥7d B组。采用面对面的方式对受试者进行助听器效果国际性问卷(International outcome Inventory for hearing aids,IOI-HA)调查,获得IOI-HA的子量表1、子量表2及总得分;分析M-ANL值及MHINT得分与IOI-HA子量表1、子量表2、及总得分的相关性;比较两组IOI-HA量表得分及MHINT得分的差异性。结果(1)M-ANL值与IOI-HA子量表1和量表总得分无相关性(P>0.05),与子量表2存在负相关(r=-0.528,P<0.05);MHINT得分与IOI-HA子量表1、2、及总得分之间均存在相关性(P<0.05);(2)M-ANL值<7d B HL组与M-ANL值≥7d B HL组的IOI-HA子量表1、子量表2、及总得分均无明显的统计学差异;(3)M-ANL值<7d B组的MHINT平均得分为78.6±26.5%;M-ANL值≥7d B组的MHINT平均得分为52.4±9.2%,差异具有统计学意义(P<0.05)(4)M-ANL值与MHINT得分呈现负相关(r=-0.505,P=0.023);差异具有统计学意义,M-ANL值越小,MHINT得分越高。结论 M-ANL测试及MHINT测试,在助听器效果评估方面有着不同的临床应用价值,M-ANL测试或许可以用于预估助听器的验配效果,而MHINT测试建议主要用于助听器验配后的效果评估。

Objective To determine the value of mandarin acceptable noise level test and mandarin hearing in noise test in assessing outcomes of hearing aids in older populations. Methods Mandarin acceptable noise level test （M-ANL） and mandarin hearing in noise test （signal-to-noise ratio=10dB） were conducted in 20 subjects with presbycusis after they were fitted with hearing aids. Participants in this study were divided into an ANL 〈 7 dB group and an ANL 〉_ 7 dB group according to a previous study by Nabelek et al. The International outcome Inventory for hearing aids （IOI-HA） was administered face-to-face foe IOI-HA sub-scale 1, sub-scale 2 and total scores. Correlations among M-ANL values and MH1NT scores and IOI-HA scores were analyzed. IOI-HA and MHINT scores were compared between the two groups. Results 1） Pear- son correlation analysis showed no correlation between M-ANL values and IOI-HA sub-scale 1 scores or IOI-HA total scores （p〉 0.05）, but a negative association between IOI-HA sub-scale 2 and M-ANL values （r=-0.528, p〈0.05）. MHIN scores after hearing aid fitting showed a positive association with IOI-HA sub-scale 1, sub-scale 2 and total scores. 2） Two independent samples T test showed that there were no statisti- cally significant differences between the ANL 〈 7 dB and ANL 〉 7 dB groups regarding the IOI-HA sub-scale 1, sub-scale 2 and total scores. 3） The average MHINT score was 78.644-26.49 dB S/R for the ANL 〈 7 dB group and 52.42-4-9.24 dB S/R in the ANL 〉 7 dB group, respectively （t=2.333, p=0.031）. 4） Pearson correla- tion analysis showed that M-ANL values and MH1NT scores were negatively correlated （r=-0.505, p=0.023）. Conclusion M-ANL and MHINT tests show values in evaluating outcomes of hearing aid fitting. The M-ANL test is useful to predict the effects of hearing aid fitting, while the MHINT test can be used to evalu- ate the outcomes.