职业性噪声聋患者焦虑及其影响因素研究

Anxiety and its influencing factors on patients with occupational noise-induced hearing loss

目的探讨职业性噪声聋(ONID)患者发生焦虑状况及其影响因素。方法采用判断抽样方法,以220例ONID患者为ONID组,以200名无接触职业性噪声的健康人群为对照组。采用《焦虑自评量表》《抑郁自评量表》《匹兹堡睡眠质量指数量表》对2组人群进行调查;并采用《耳鸣残疾量表》和纯音气导测听评估ONID组患者耳鸣及听力损伤程度。结果ONID组人群焦虑、抑郁和睡眠障碍检出率均高于对照组(52.7%vs 9.0%,55.0%vs 15.0%,52.3%vs 7.0%,P<0.05)。与ONID无焦虑亚组比较,ONID并发焦虑亚组患者病程较长(1.0 vs 2.0年,P<0.01),耳鸣、抑郁、睡眠障碍的检出率均升高(92.3%vs 100.0%,18.3%vs 87.9%,19.2%vs 81.9%,P<0.01)。多因素Logistic回归分析结果显示,病程越长、耳鸣严重程度越高的ONID患者越易并发焦虑[优势比(OR)及其95%可信区间(CI)分别为1.35(1.10~1.65)和2.94(1.56~5.54),P<0.01];有睡眠障碍的ONID患者并发焦虑的风险高于无睡眠障碍者[OR(95%CI)为12.78(5.90~27.64),P<0.01]。结论ONID患者容易并发焦虑;病程、耳鸣严重程度和睡眠障碍均是导致ONID患者焦虑情绪的危险因素。

Objective To explore the status and its influencing factors of anxiety symptoms in patients with occupational noise-induced deafness(ONID).Methods A total of 220 ONID patients were selected as the ONID group,and 200 healthy participants without noise exposure were selected as the control group by judge sampling method.The two groups were investigated by the Self-Rating Anxiety Scale,Self-Rating Depression Scale and Pittsburgh Sleep Quality Index.The Tinnitus Handicap Inventory was used to evaluate the disability levels of tinnitus,and pure-tone audiometry was used to assess the degree of tinnitus and hearing impairment in the ONID group.Results The incidence of anxiety,depression,and sleep disorder were higher in the ONID group than that in the control group(52.7%vs 9.0%,55.0%vs 15.0%,52.3%vs 7.0%,P<0.05).In ONID with anxiety subgroup,the duration of disease was longer(1.0 vs 2.0 years,P<0.01),incidences of tinnitus,depression and sleep disorder were higher than those in ONID without anxiety subgroup(92.3%vs 100.0%,18.3%vs 87.9%,19.2%vs 81.9%,P<0.01).The result of multivariate logistic regression analysis showed that the longer the duration of disease and the more severe of the tinnitus,the higher the risk of anxiety symptoms in patients with ONID[the odds ratio(OR)and its 95%confidence interval(CI)were 1.35(1.10-1.65)and 2.94(1.56-5.54)respectively,P<0.01].The risk of anxiety in patients with sleep disorders was higher than those without sleep disorders[OR(95%CI)was 12.78(5.90-27.64),P<0.01].Conclusion The ONID patients are more likely to have anxiety.The duration of disease,severity of tinnitus and sleep disorders are the risk factors causing anxiety in ONID patients.