普通话噪声下言语识别及其与年龄相关听力损失和认知水平的关系

Relationship among Speech Perception in Noise, Age-related Hearing Loss and Cognition in Putonghua

目的探讨汉语普通话条件下,年龄相关的听力损失和认知水平与噪声下言语识别能力的关系。方法2018 年1 月至10 月,耳鼻喉科就诊的中老年门诊患者31 例(52~75岁),根据纯音测听平均听阈分为听力正常组和听力下降组。采用“心爱飞扬”中文言语测听平台和剑桥神经心理学成套测试,评估受试者噪声下言语识别能力和非口语测试条件下的情景记忆、工作记忆和执行能力。结果两组间噪声下言语识别能力和情景记忆、执行能力均有显著性差异(U < 68, P < 0.05)。无论信号和噪声是否分离,年龄相关外周听力水平与噪声下言语识别能力正相关;与情景记忆、执行能力正相关(r > 0.360,P < 0.05)。噪声下言语识别任务难度越大,信噪比与认知能力的相关性越明显。结论汉语普通话条件下,中老年人在噪声下言语识别能力表现下降,与年龄相关的听力下降是主要原因之一。听力下降导致情景记忆和执行能力衰减,反过来影响噪声下言语识别能力。噪声下言语识别难度越大,对认知水平的依赖越明显。

Objective To explore the relationship between age-related hearing loss, cognitive level and speech perception in noise in Putonghua. Methods From January to October 2018, 31 outpatients who visited the department of otolaryngology (aged 52-75) were divided into hearing normal (HN) group and hearing loss (HL) group according to the results of the average threshold measured with pure-tone audiometry. They were assessed with the computer-aided Chinese Speech Test Platform and the Cambridge Neuropsychological Test Automated Battery, which respectively evaluated the speech perception ability in noise, and the episodic memory, working memory and executive ability under nonverbal stimulation. Results There were significant differences in speech perception ability, episodic memory and executive ability between the two groups (U < 68, P < 0.05). The hearing level correlated to the speech perception in noise, whatever the speech and noise were separated, as well as the episodic memory, working memory and executive ability (r > 0.360, P < 0.05). The more difficult the speech perception task was, the more significant the correlation between signal-noise ratio and cognitive ability was. Conclusion Under the condition of Putonghua, age-related hearing loss is one of the main reasons for the decline of speech perception in noise in the old adults. Hearing loss leads to the decline of episodic memory and executive ability, which in turn affects speech perception in noise. The more difficulty it is to recognize speech in noise, the greater the dependence on cognitive level.