2型糖尿病患者听力损失的影响因素及其与眼底病变相关性

Influencing factors of hearing loss and its correlation with retinopathy in type 2 diabetes mellitus patients

目的探讨2型糖尿病患者眼底病变(diabetic retinopathy,DR)与听力损害相关性,探讨2型糖尿病听力损害的相关危险因素。方法以2013年10月至2014年12月首都医科大学附属北京同仁医院内分泌科就诊的糖尿病患者73例为观察对象。询问相关病史,有无主观耳科症状,进行糖尿病眼底检查,纯音听力测定、声导抗检查。同时完善血糖、血压、血脂等检查。依照糖尿病眼底病变、听力损失情况进行分组,对比检查指标有无统计学差异。结果听力损失组与正常组比较,年龄(P=0. 005)、DR(P=0. 006)增加,高频听力受损组与正常组比较,年龄(P=0. 001)、DR(P=0. 017)增加。Logistic回归分析结果显示,DR对平均听力受损有影响(OR=6. 499,95%CI:1. 546~27. 317,P=0. 011),对高频听力受损有影响(OR=6. 763,95%CI:1. 285~35. 580,P=0. 024)。结论糖尿病听力损失与DR有关,可无自觉症状。发现DR的患者应积极进行听力筛查,以便早期发现听力损害及时干预。

Objective To analyze the association between diabetic retinopathy( DR) and hearing loss in diabetes mellitus( DM)patients and to investigate the factors which affect hearing among DM patients. Methods Questionnaires and pure tone audiometry were performed in 73 patients with type 2 DM,The average age was( 53. 0 ± 8. 4) years,the course of diabetes was( 10. 3 ± 7. 0) years,who visited Beijing Tongren Hospital,Capital Medical University from October 2013 to December 2014. The patients were categorized into groups according to hearing loss and DR. The examination of the ocular fundus,the pure tone air and bone conduction threshold testing,Hemoglobin A,blood pressure,lipid and other examinations were carried out. Results In all of the 73 subjects with diabetes,pure tone audiometry confirmed the incidence of hearing loss in 26. 0%,including10. 5% cases who did not complained of hearing loss. The incidence of retinopathy is 39. 7%. The age( P = 0. 005) and DR( P = 0. 006) exacerbated hearing loss in the mean hearing loss group of diabetes mellitus compared with the normal group. It is the same in the high-frequency hearing loss group compared with the normal group,with the age( P = 0. 001) and DR( P = 0. 017). Logistic regression analysis showed that the DR( OR = 6. 499,95% CI: 1. 546-27. 317,P = 0. 011) significantly exacerbated the hearing loss in the both average hearing loss and high frequency hearing loss DR( OR =4. 448,95% CI: 1. 195-16. 551,P = 0. 026). Conclusion There have significantly association between DR and hearing loss in DM patients. The patient’s subjective feeling did not reflect exactly their hearing function. The hearing screening should be performed in time for the patients with DR.