成人听力障碍筛查量表和噪声下数字言语测试在听力损失患者中的应用

Application of hearing handicap inventory for adultscreening and digits in noise in patients with hearing loss

目的研究成人听力障碍筛查量表(hearing handicap inventory for adult-screening,HHIA-S)、噪声下数字言语测试(digits in noise,DIN)与听力损失的相关性,分析HHIA-S与DIN在听力损失诊断中的灵敏度和特异度。方法本研究招募听力正常者29名、感音神经性听力损失患者38例,按双耳纯音听阈平均值PTA_(0.5~4 kHz)分为轻度组19例,中度组10例,重度组9例,依次完成纯音听阈测试、声导抗测试、听力损失自我报告、HHIA-S量表以及DIN测试。采用线性相关分析HHIA-S得分、DIN阈值与纯音听阈平均值的相关性,采用受试者工作特性曲线(receiver operating characteristic,ROC)及曲线下面积(area under the curve,AUC)确定DIN在最佳诊断截点下的灵敏度和特异度。结果①本组受试者HHIA-S得分、DIN阈值与纯音平均听阈PTA_(0.5~4 kHz)之间均呈显著相关性(P<0.01);②将HHIA-S得分>8分定义为存在听力障碍,结果显示HHIA-S量表发现听力损失的灵敏度为0.684,特异度为0.967;③DIN的最佳诊断截点(cut-off)为-16.1 dB,判断听力损失的灵敏度为0.894,特异度为1,均高于HHIA-S量表及听力损失自我报告。结论DIN作为一种快速、有效且经济、便捷的听力筛查手段,其灵敏度和特异度均高于成人听力障碍筛查量表及听力损失自我报告。

OBJECTIVE To study the correlation between hearing handicap inventory for adult-screening(HHIA-S),digits in noisetest(DIN)and hearing loss,and to analyze the sensitivity and specificity of DIN and HHIA-S in the diagnosis of hearing loss.METHODS This study recruited 29 normal hearing subjects and 38 patients with sensorineural hearing loss(according to the average pure-tone threshold PTA05-4 kHz).The patients were divided into mild hearing-level group(19 cases),moderate group(10 cases)and severe group(9 cases).All the subjects completed the pure-tone audiometry,acoustic immittance test,hearing loss self-report,HHIA-S scale and DIN test.Spearman correlation analysis was used to analyze the correlation between DIN threshold,HHIA-S score and the average PTA_(0.5-4kHz).Receiver operating characteristic curve(ROC)and area under the curve(AUC)were used to determine the sensitivity and specificity of DIN(with the optimal cut-off point)and HHIA-S.RESULTS 1.There was a positive correlation between the average threshold PTA_(0.5-4kHz)and DIN test results,as well as HHIA-S score(P<0.01).2."HHIA-S score>8"is defined as the cut-point of hearing impairment.The results show that the sensitivity and specificity of HHIA-S for hearing lossare 0.684 and 0.967 respectively.3.The optimal cut-off point of DIN is-16.1 dB,the sensitivity and specificity for hearing loss are 0.894 and 1,higher than HHIA-S and self-report of hearing loss.CONCLUSION As a fast,effective,economical and convenient hearing-screening tool,DIN has better sensitivity and specificity than that of HHIA-S and the self-report hearing loss.