单句询问与中文版老年听力障碍筛查量表在社区50岁以上人群听力筛查中的应用

Comparison of the Performance between the Mandarin Version of HHIE-S and Single Question in the Hearing Screening in Old Adults

目的 探讨中文版老年听力障碍筛查量表（Chinese version of hearing handicap inventory for the elderly-screening,中文版HHIE-S）和单句询问应用于社区50岁以上人群听力筛查的意义。方法 使用中文版HHIE-S量表及单句询问“您现在觉得听力有问题吗？”两种方法对某社区570例50~85岁中、老年人进行听力筛查,以0.5、1、2、4kHz平均纯音听阈（pure-tone audiometry,PTA）作为金标准,分别在PTA〉25、〉40、〉60dB HL三种不同听力损失分级条件下,计算单句询问及中文版HHIE-S量表的敏感性、特异性、阳性预测值及阴性预测值,比较两种方法对不同程度听力损失者的检出能力。结果570例中,PTA〉25dB HL 478例,占83.86%,中文版HHIE-S量表〉8分者315例,占55.46%,单句询问阳性者299例,占52.46%。在三个不同听力损失分级条件下中文版HHIE-S量表〉8分的敏感性分别为61%、85%、96%,特异性分别为72%、58%、47%,单句询问阳性组的敏感性为58%、81%、100%,特异性为75%、61%、50%,两种听力筛查方法经统计分析比较差异无统计学意义（P〉0.05）。结论 中文版HHIE-S量表与单句询问方法对中重度听力损失中、老年人的筛查都有较高的敏感性,可根据研究目的用于临床及基层大样本中、老年人群的听力筛查。

Objective To compare the performance of Mandarin screening version of hearing handicap inven- tory in elderly （HHIE--S） and the single question of hearing loss in the hearing screening in the old adults. Methods A total of 570 participants, aged from 50-85 years, of native Mandarin speakers were tested with standard pure tone audiometry （PTA）, HHIE--S and single question ＂Are you now having difficulty in hearing？＂. HHIE--S〉8 was taken as an indicator of hearing handicap. Sensitivity, specificity, negative predictive values and positive predic- tive values of both HHIE--S and single question inquiry when 0.5-4 kHz PTA average 〉 25 dB, 〉40 dB and 60 dB were compared. Results The prevalence was 83.9% （478） measured by PTA. The prevalence was 55.3% and 52.5% for HHIE--S and positive answer for single question, respectively. The sensitivity of HHIE--S when the participants grouped with 0.5-4 kHz PTA average 〉 25 dB,〉40 dB and 〉60 dB was 61%, 85% and 96%, respectively, whereas the sensitivity of single question of the above 3 conditions was 58%, 81% and 100%, respec- tively. The specificity of HHIE--S decreased with greater hearing loss. It was 72%, 88% and 47% respectively for HHIE--S and 75%, 61% and 50% for the single question. There was no significant difference either for sensitivityand specificity between the HHIE--S and the single question. Conclusion Both the Mandarin version of HHIE--S and single question are effective in the hearing screening of old adults. Depending on the purpose and availability of resources, one or both of them can be adopted.