噪声下数字言语测试在听力筛查中的应用研究

Application of digits in noise test in hearing screening

目的探讨利用噪声下数字言语测试(digits in noise,DIN)预测不同程度听力损失的实用性和有效性。方法纳入听力正常者70名;听力损失患者共94例,包括轻度组36例,中度组34例及重度组24例。将纯音听阈PTA_(0.5~4 kHz)与言语识别阈(speech reception threshold,SRT)进行相关性分析,绘制受试者工作特征曲线(receiver operating characteristic curve,ROC)。结果SRT值与PTA_(0.5~4 kHz)呈现较好的正相关关系。用SRT值区分轻度、中度、重度听力损失的ROC曲线显示DIN具有良好的诊断及分类功能。通过计算不同听力损失程度的最佳截断值,得出当SRT≤-16.4 dB、-16.4 dB-1.8 dB时,提示受试者听力正常、可能存在轻度、中度及重度听力下降。通过DIN分辨不同程度听力损失的灵敏度和特异度均较高。结论DIN可以作为预测不同程度听力损失的有效筛查工具。

OBJECTIVE To verify the practicability and effectiveness of digits-in-noise test for the discrimination of hearing loss at different levels.METHODS Seventy normal-hearing subjects and 94 patients were recruited.The patients were divided into mild hearing-level group(36 cases),moderate group(34 cases)and severe group(24 cases).Correlation analysis was performed between PTA_(0.5-4 kHz)and speech reception threshold(SRT).Receiver operating characteristic curve(ROC)was plotted and sensitivity and specificity were calculated.RESULTS There was a positive correlation between the average threshold PTA_(0.5-4 kHz)and SRT.Based on the ROC curves we used SRT to distinguish mild,moderate and severe hearing-loss patients,indicating the good diagnostic and classification utility of DIN.The optimal cut-off points were calculated:SRT<-16.4 dB(normal hearing),-16.4 dB<SRT<-9.4 dB(mild hearing loss),-9.4 dB<SRT<-1.8 dB(moderate hearing loss),and SRT>-1.8 dB(severe hearing loss).In this study,the sensitivity and specificity for discriminating the hearing loss at different degrees were high.CONCLUSION DIN can be used as an effective hearing-screening tool to predict different degrees of hearing loss.