单侧特发性耳鸣临床特点和情绪、认知特征的对比分析及相关性研究

The clinical features and emotional,cognitive differences and the correlation in unilateral idiopathic tinnitus patients

目的分析左、右侧特发性耳鸣临床特点和情绪、认知状态差异及相关性。方法入选左、右侧耳鸣各44、36例,采集临床资料及耳鸣障碍评估量表(tinnitus handicap inventory,THI)、贝克抑郁量表(Beck depression inventory,BDI)、状态特质焦虑量表(state trait anxiety inventory,STAI)、蒙特利尔认知评估量表(Montreal cognitive assessment,MoCA)评估。结果男性左侧耳鸣发生率明显高于女性患者(68.2%vs 31.8%)。左侧耳鸣伴听力下降发生率明显高于右侧(90.9%vs 69.4%)。两组间年龄、体质量指数(BMI)、受教育年限、耳鸣持续时间、听力阈值和THI、BDI、状态焦虑量表(S-AI)、特质焦虑量表(T-AI)、MoCA评分无显著性差异。影响日常生活和睡眠、抑郁、状态焦虑、特质焦虑和认知损害的发生率是23.8%、33.8%、17.5%、6.3%和33.8%。耳鸣严重程度与抑郁、状态焦虑、特质焦虑和认知功能损害呈正相关,耳聋严重程度与认知功能损害呈正相关。结论单侧特发性耳鸣较严重,抑郁、焦虑和认知损害发生率高且与耳鸣和耳聋严重程度密切相关。

OBJECTIVE To analyze the clinical features,emotional and cognitive states and their correlations in unilateral idiopathic tinnitus patients.METHODS Thirty-six right and 44 left tinnitus patients were prospectively enrolled.The age,gender,body mass index(BMI),years of education,tinnitus duration and hearing were recorded.Tinnitus handicap inventory(THI),Beck depression inventory(BDI),state trait anxiety inventory(STAI),and Montreal cognitive assessment(MoCA)were used to analyze.The correlation between clinical features of tinnitus and emotional and cognitive states were evaluated.RESULTS The incidence of left tinnitus in male was significant higher than that in female(68.2%vs 31.8%).The incidence of hearing loss in left tinnitus patients was significantly increased than that in right tinnitus patients.There were no difference in age,BMI,years of education,tinnitus duration,hearing level,and the THI,BDI,STAI,MoCA scores between the two groups.23.8%of tinnitus interfered with patients’daily activities and sleep,33.8%of patients suffered from depression,17.5%from state anxiety,6.3%from trait anxiety,and 33.8%from cognitive impairment.The depression,anxiety,and cognitive impairment were positively correlated with increased THI score,and cognitive impairment was positively correlated with increased hearing loss.CONCLUSION Unilateral idiopathic tinnitus patients usually present with high incidence of depression,anxiety,and cognitive impairment.The severity of tinnitus and hearing loss are closely related with the occurrence of emotional and cognitive abnormalities.