健康中老年人的超高频听阈测定

Ultrahigh-frequency hearing thresholds in middle aged and elderly healthy adults

目的：分析常规听力检查正常的健康中老年人的超高频听阈情况。方法：将50-69岁的健康中老年人分为50-59岁组和〉59-69岁组,双耳均接受常规频率（0.25、0.50、1.00、2.00、4.00、6.00、8.00kHz）纯音听阈检测和超高频（9.0、10.0、11.5、12.5、14.0、16.0、18.0、20.0kHz）纯音测听,分析各频率的听阈情况。超高频测听检测2次,以评价超高频测听的稳定性。同期选取听力正常的健康成年人中听力最佳者（年龄20-29岁）,作为正常听力对照组（20-29岁组）。结果：常规频率纯音测听,中老年人的各频率阈值显著性高于青年人（均P〈0.05）;中老年人的纯音听阈在4kHz处即开始明显提高;〉59-69岁组较50-59岁组各频率听阈均有增高趋势,但仅4kHz听阈组间差异有统计学意义（P〈0.05）。2个中老年组的各超高频阈值显著高于对照组（均P〈0.05）;〉59-69岁组较50-59岁组9.0、10.0、11.5和12.5kHz的听阈值均显著提高（均P〈0.05）。从12.5kHz开始中老年人群出现无法检出听阈者,检出率显著低于对照组（均P〈0.05）,〉59-69岁组较50-59岁组的检出率有降低趋势（P〉0.05）;18kHz和20kHz 2个组均没有检出者。50-59岁组〈14kHz的各频率听阈的组内标准差明显大于对照组;〉59-69岁组〈11.5kHz的听阈标准差明显大于对照组;50-59岁组6kHz以上频率的听阈标准差明显大于〉59-69岁组（均P〈0.05）。结论：中老年人听力损失的早期从4kHz开始;随着年龄增长,超高频听阈提高,可以作为年龄相关的听力损失的早期诊断指标;但超过14kHz后超高频敏感性降低。

Objective：To investigate the ultrahigh-frequency（UHF）hearing thresholds in middle-aged and elderly healthy subjects.Method：Healthy subjects（age range：50-69）were divided into two groups,i.e.50-59year-old group and 〉59-69year-old group.Each subject was tested with both conventional-frequency（0.25,0.50,1.00,2.00,4.00,6.00 and 8.00kHz）and ultrahigh-frequency（9.0,10.0,11.5,12.5,14.0,16.0,18.0,and 20.0kHz）audiometry.UHF was performed twice to evaluate the reliability.The best hearings among 20-29 aged healthy adults were considered as normal controls.Results：Seventy five middle-aged and elderly subjects were included,with 39subjects（78ears）being 〉50-59 years old and 36（72ears）being59-69year-old.Eighteen subjects（36ears）aging from 20 to 29were considers as controls.For the conventional-frequency,the hearing thresholds in middle-aged and elderly people were significantly higher than those in young people（all P〈0.05）,especially at≥4kHz.Although the conventional-frequency thresholds in 〉59-69year-old group were higher than those in 50-59year-old,the difference was significant just at 4kHz（P〈0.05）.The UHF thresholds in middle-aged and elderly people were significantly higher than those in young people（all P〈0.05）.The thresholds at9,10,11.5and 12.5kHz in 〉59-69year-old people were significantly increased than those in 50-59year-old counterparts（all P〈0.05）.Hearing threshold at≥12.5kHz couldn＇t be detected in some subjects in middle-aged and elderly group.The response rate at UHF in 〉59-69year-old people were just higher than that in 50-59year-old counterparts（P〈0.05）,and none responded at 18 and 20kHz.The standard deviations（SDs）for 14kHz in 50-59year-old and for〈11.5kHz in〉59-69 year-old subjects,were both higher than that in 20-29year-old counterparts.Above 6kHz,the SDs in 50-59year-old subjects were significantly higher than those in 〉59-69 year-old subjects（all P〈0.05）.Conclusion：For middle-aged and elderly people,the hearing loss may occur from 4kHz.Hearing thresholds at UHF were increased with age,and it might be used as an early indicator for age-induced hearing loss.However,the UHF sensitivity decreased as the frequency increased beyond 14 kHz.