2171例耳鸣患者的临床特征分析

Clinical Characteristics of Tinnitus:An Analysis of 2171 Patients

目的探讨耳鸣患者的临床特征,为耳鸣诊治提供参考。方法收集2014年1月至2015年12月就诊于中山大学孙逸仙纪念医院耳鼻喉科门诊以耳鸣为第一主诉的2 171例(2 736耳)耳鸣患者的临床资料,以耳鸣残疾量表(tinnitus handicap inventory,THI)及视觉模拟评分(visual analogue scale,VAS)评估耳鸣的严重程度,并分析耳鸣的发病年龄、耳鸣侧别、听力状况及可能病因等基本特征。结果 2 171例耳鸣患者平均年龄为44.08±15.37岁,其中41~50岁为分布最集中的年龄段(491例,22.60%),其次为31~40岁(445例,20.50%)1~60岁(438例,20.20%);主观性耳鸣2 120例(97.65%),客观性耳鸣51例(2.35%);单侧耳鸣(1 606例,73.98%)多于双侧耳鸣(539例,24.83%),颅鸣最少(26例,1.19%);2 736侧耳鸣耳8 000 Hz的平均听阈为69.26±27.70dB HL,高于1 606侧非耳鸣耳(54.16±30.98dB HL);THI分级以2、3级为主(55.78%,1 211/2 171),VAS分级以轻、中度耳鸣为主(83.83%,1 820/2 171);音调匹配以高频多见(4~8kHz,1 199例,55.23%);位于前三位的可能病因为不明原因591例(27.22%)、突发性聋549例(25.29%)及中耳疾病270例(12.44%)。结论本组耳鸣患者中以主观性耳鸣为主,中青年者居多,单侧耳鸣多于双侧耳鸣,耳鸣与听力关系密切;引起耳鸣的病因多而复杂,部分患者不明原因或与耳疾有关,习服治疗是值得推广的治疗方法。

Objective To evaluate and characterize tinnitus patients,and provide profiles for further studying tinnitus.Methods This study included 2 171 tinnitus patients seeking treatment between Janurary 2014 and December 2015 from department of head and neck surgery,Sun Yixian Memorial Hospital,Zhongshan University.Tinnitus measurements consisted of pure tone audiometry and tinnitus matching procedures.The characteristics of tinnitus were analyzed by the essential information and auditory checks of the patients.Results Average age was 44.08±15.37 years old.Tinnitus frequently occurred between 41 to 50 years old（491 cases,22.60%）.Unilateral tinnitus was more than bilateral tinnitus,while the cranial tinnitus was rare.The patients with mild or moderate tinnitus had the largest population,with higher average hearing threshold at 8 000 Hz in tinnitus ear than non tinnitus ear.The highest frequency of tinnitus matching frequency was high frequency（4~8 kHz）.The first three causes for tinnitus were unknown reasons,sudden deafness and middle ear disease.Conclusion Larger population was subjective tinnitus.Tinnitus was closely related with hearing loss.The causes for tinnitus were complex.Tinnitus retraining therapy is a treatment that is worth to be popularized.