伴围绝经期综合征的主观性耳鸣患者临床特征分析

Analysis of clinical characteristics of subjective tinnitus in patients with perimenopausal syndrome

目的观察与分析围绝经期女性的耳鸣特征。方法对就诊我科248例患主观性急性耳鸣伴围绝经期综合征女性进行纯音听阈测试、耳鸣频率和响度匹配测试、耳鸣问卷调查、睡眠质量评价和血清促卵泡刺激素(follicle-stimulating hormone,FSH)测定。结果单耳鸣多于双耳鸣,差异有统计学意义(χ~2=97.58,P<0.05),左、右耳耳鸣发生率基本相当,差异无统计学意义;高频耳鸣占总数的62.73%、中频占2.80%、低频占34.47%;耳鸣频率与听力下降频率无明显相关性,与严重程度亦无明显相关性;耳鸣残疾评估量表(tinnitus handicap inventory,THI)响度评级主要为2、3级,占72.18%,其次为1、4级,占24.60%,5级极少,仅占3.22%;FSH水平与耳鸣严重程度有相关性,与耳鸣响度无明显相关性;睡眠障碍发生率58.06%,随耳鸣程度增加,睡眠障碍发生率增加,耳鸣程度与睡眠质量呈正相关。结论围绝经期女性耳鸣特征、病因与发病机制与听觉系统病变的耳鸣有所不同,主要与FSH水平有关。耳科医师应注意鉴别诊断,综合分析和治疗。

OBJECTIVE To observe and analyze the characteristics of tinnitus in perimenopausal women. METHODS To do sleep quality assessment, pure-tone test, tinnitus frequency and loudness match, tinnitus questionnaire investigation and FSH testfor 248 subjective tinnitus women with perimenopausal syndrome. RESULTS There was more single tinnitus than double tinnitus, the difference was statistically significant （P〈0.05）; The incidence of tinnitus on left and right ears was basically the same, the difference was not statistically significant;High frequency tinnitus accounted for 62.73%, medium frequency was 2.80%, low frequency was 34.47%; There was no significant correlation between the frequency of tinnitus and hearing loss,There was no significant correlation between loudness and severity of tinnitus; Tinnitus THI loudness rating is mainly grade 2 and 3, accounting for 72.18%, followed by gradel and grade 4, accounting for 24.60%, grade 5 is very few, only 3.22%; There was significant correlation between the FSH and severity of tinnitus, but there was no significant correlation between the FSH and loudness of tinnitus. The incidence of sleep disorders was 58.06%.With the degree of tinnitus increased, the incidence of sleep disorders increased, and the degree of tinnitus was positively correlated with the quality of sleep. CONCLUSION The characteristics, etiology and pathogenesis of tinnitus in perimenopausal women are different from that of tinnitus happened in auditory system, mainly relate to FSH level. Otologists should pay attention to differential diagnosis, comprehensive analysis and treatment.