中文版老年听力障碍筛查量表评分与纯音听阈测试的比较研究

A Comparative Study of the Chinese Version of the Hearing Handicap Inventory for the Elderly-Screening and Pure Tone Audiometry

目的探讨中文版老年听力障碍筛查量表(hearing handicap inventory for the elderly-screening,HHIE-S)评分与纯音听阈测试的关联性与差异性,为该量表的临床应用提供依据。方法275例老年受试者(听力正常者47例、不同程度听力损失者228例)填写中文版HHIE-S量表获得评分,并进行纯音听阈测试,比较受试者中文版HHIE-S量表评分与较好耳500、1000、2000、4000 Hz纯音气导听阈平均值(PTA)之间的关联性与差异性。结果275例受试者中,PTA正常组47例,HHIE-S评分为无听力障碍者占80.85%(38/47);PTA轻度听力损失组101例,HHIE-S评分为轻中度听障者占38.61%(39/101);PTA中度听力损失组110例,HHIE-S评分为轻中度听障者占40.0%(44/110);PTA重度听力损失组17例,HHIE-S评分为重度听障者占82.35%(14/17)。HHIE-S与纯音听阈测试结果的Kappa系数为0.210(P<0.001)。HHIE-S评分与PTA的Pearson相关系数r为0.722(P<0.001)。以PTA≤25 dB HL为听力正常、HHIE-S评分≤8分表示无听力障碍,HHIE-S量表的敏感性为61.0%,特异性为80.9%,阳性预测值为93.9%,阴性预测值为29.9%。结论HHIE-S量表与纯音听阈测试既有较好的关联性,又有差异性,二者联合应用可以全面评估老年人的听力状况。

Objective To study the correlation and difference between the Chinese version of the handicap inventory for the elderly-screening and pure tone audiometry,and to provide evidence for the clinical application of the scale.Methods A total of 275 older people with normal hearing and hearing loss of different degrees completed pure tone audiometry,Chinese version of HHIE-S scale and general situation questionnaire.The correlation and difference between the score of Chinese version of HHIE-S scale and the mean value of pure tone air conduction threshold(PTA)of better ears 500,1000,2000 and 4000 Hz were compared.Results Among 275 subjects,47 were the normal PTA group and 80.85%(38/47)had no hearing impairment in HHIE-S score.101 were in PTA mild hearing loss group,and 38.61%(39/101)had mild to moderate hearing impairment in mild hearing impairment group.110 were in the PTA moderate hearing loss,and 40.0%(44/110)had mild to moderate hearing impairment in moderate hearing impairment group.17 were in the PTA severe hearing loss group,and 82.35%(14/17)had severe hearing impairment in severe hearing impairment group.The Kappa coefficient of HHIE-S score and PTA was 0.210(P<0.001).The pearson correlation coefficientr was 0.722(P<0.001).If PTA≤25 dB HL and HHIE-S score≤8 is regarded as normal hearing,the sensitivity,specificity,positive predictive value and negative predictive value of the HHIE-S scale were 61.0%,80.9%,93.9%and 29.9%,respectively.Conclusion HHIE-S scale and pure tone audiometry results have good correlation,but also have differences.The combined application of HHIE-S scale and pure tone audiometry can comprehensively assess the hearing status of the elderly.