特发性耳鸣患者心理声学及临床特征研究

Psychoacoustic and clinical features of patients with idiopathic tinnitus

目的:探讨特发性耳鸣患者的心理声学及临床特征,了解耳鸣频率、响度与听力损失之间的联系和规律,为耳鸣的个性化诊治提供依据。方法:对110例特发性耳鸣患者进行系统的耳科专业检查、听力学检查、耳鸣精细化检查、病史询问和耳鸣残疾度量表(THI)调查。结果:患者年龄以20～60岁最多(95.45%),20岁以下及60岁以上者明显减少;耳鸣位点频率与听力损失最大频率完全一致的共有67例(60.9%),Pearson相关性分析得出二者具有相关性(r=0.989,P<0.05);耳鸣响度匹配结果大多集中在40～60dBSL(37.3%),Pearson相关性分析得出其与听损程度存在相关性(r=0.932,P<0.05)。该研究采用多元复合声治疗耳鸣,总体有效率达67.3%,患者残余抑制试验的结果与多元复合声治疗效果的评价分级存在显著相关性(r=0.438,P<0.05);残余抑制试验结果部分阳性和阳性、阴性组的THI分数差异有统计学意义(r=-2.464,P<0.05)。THI和病程之间无相关性(r=-0.047,P>0.05)。结论:患者的耳鸣频率和响度与听力损失程度之间存在一定相关性;残余抑制试验的结果可以提示患者声治疗的有效性且可以影响患者的THI得分。耳鸣精细化检查可以为耳鸣患者早期听力损失的检出提供临床参考依据。

Objective：The aim of this study is to explore the psychoacoustic and clinical features of patients with idiopathic tinnitus,to understand the relationship and regularity between tinnitus frequency,loudness and hearing loss,and to provide a basis for personalized diagnosis and treatment of tinnitus.Method：A total of 110 patients with idiopathic tinnitus underwent systematic otological professional examination,audiological examination,tinnitus refinement examination,medical history inquiry and tinnitus disability scale（THI）survey.Result：Tinnitus more frequently occurred between 20 to 60 years of age（95.45%）,a significant decrease in people under the age of 20 and over the age of 60;67 cases（60.9%）of the tinnitus frequency were completely consistent with the maximum frequency of hearing loss,The Pearson test showed that tinnitus frequency was correlated to frequency of hearing loss（r=0.989,P〈0.05）.Tinnitus loudness pitch results are mostly concentrated between 40-60 dBSL,The Pearson test showed that tinnitus loudness was correlated to hearing loss（r=0.932,P〈0.05）;The total effective rate of sound therapy was 67.3%,There was a correlation between Residual inhibition and sound therapy（r=0.438,P〈0.05）;No statistic difference was found between THI scores and Tinnitus duration（r=-0.047,P〈0.05）.Conclusion：There was a correlation between tinnitus pitch and hearing loss.Residual inhibition may indicate the effectiveness of the sound therapy and may affect the patient＇s THI score.Full Precision Test can provide clinical reference for early detection of hearing loss in tinnitus patients.