苏州地区0~14岁儿童听力障碍流行病学调查及发病因素的Logistic回归分析

Epidemiological Investigation of Hearing Impairment in Children Aged 0~14 Years in Suzhou and Logistic Regression Analysis of its Pathogenic Factors

目的:调查苏州地区0~14岁儿童听力障碍流行病学情况,并分析发病的危险因素。方法:采用多阶段、随机抽样的方法,于2020年1月~2022年1月期间在本地区46个街道和51个镇中,抽取调查样本1478例。采用《WHO耳疾与听力障碍调查方案》进行现场调查,用AA222听力计对0~14岁儿童进行纯音测听,听力阈值≥26dB提示存在听力障碍。调查苏州地区0~14岁儿童听力障碍流行病学情况,并分析听力障碍发病的危险因素。结果:纳入0~14岁研究对象1478例,资料齐全者1459例,回收率98.71%。根据是否发生听力障碍将所有研究对象分为听力障碍组(n=42)和无听力障碍组(n=1417)。听力障碍的发生率为2.88%,其中男性的患病率高于女性,8~14岁的患病率高于0~7岁,城镇患病率高于农村。听力障碍发病与曾用过耳毒性药物、阳性耳聋家族史、母围产期感染、高胆红素血症、新生儿窒息、母孕期合并疾病、母孕期不良生活习惯、母孕期不良社会环境因素、性别、年龄有关(P<0.05),而与头颈部畸形、细菌性脑膜炎、婴幼儿期有既往疾病史、居住地无关(P>0.05)。多因素Logistic回归分析,结果显示:年龄8~14岁、曾用过耳毒性药物、有母围产期感染、有高胆红素血症、有母孕期合并疾病、有母孕期不良生活习惯、有母孕期不良社会环境因素、有阳性耳聋家族史、有新生儿窒息是听力障碍发病的危险因素(P<0.05)。结论:苏州地区0~14岁儿童听力障碍的发生率为2.88%,8~14岁的居多,发病受到曾用过耳毒性药物、母围产期感染、高胆红素血症、母孕期合并疾病、母孕期不良生活习惯、母孕期不良社会环境因素、阳性耳聋家族史、新生儿窒息等多种因素的影响。

Objective:To investigate the epidemiological situation of hearing impairment in children aged 0~14 years in Suzhou,and to analyze the risk factors of the disease.Methods:Using the method of multi-stage and random sampling,1478 samples were selected from 46 streets and 51 towns in the region from January 2020 to January 2022.On-site investigation was carried out using the《WHO Survey Plan on Ear Diseases and Hearing Impairment》.Pure tone audiometry was performed on children aged 0~14 years with AA222 screening audiometer.Hearing threshold greater than or equal to 26dB indicated that there was hearing impairment.The epidemiology of hearing impairment in children aged 0~14 years in Suzhou was investigated,and the risk factors of hearing impairment were analyzed.Results:1478 subjects aged 0~14 years were included,1459 of whom had complete data,with a recovery rate of 98.71%.All the subjects were divided into hearing impairment group(n=42)and non-hearing impairment group(n=1417)according to the occurrence of hearing impairment.The incidence of hearing impairment was 2.88%.Among them,the prevalence rate of male was higher than that of female,the prevalence rate of 8~14 years was higher than that of 0~7 years,and the prevalence rate of town was higher than that of countryside.The incidence of hearing impairment was related to the previous use of ototoxic drugs,family history of positive deafness,maternal perinatal infection,hyperbilirubinemia,neonatal asphyxia,maternal disease during pregnancy,adverse living habits during maternal pregnancy,adverse social environmental factors during maternal pregnancy,gender and age(P<0.05),but not related to head and neck deformities,bacterial meningitis,previous disease history in infancy and place of residence(P>0.05).Multivariate Logistic regression analysis showed that age 8~14 years,previous use of ototoxic drugs,had maternal perinatal infection,had hyperbilirubinemia,had maternal disease during pregnancy,had adverse living habits during maternal pregnancy,had adverse social environmental factors during maternal pregnancy,had family history of positive deafness,and had neonatal asphyxia were risk factors for hearing impairment(P<0.05).Conclusion:The incidence of hearing impairment in children aged 0~14 years in Suzhou is 2.88%,most of whom were aged 8~14 years.The incidence of hearing impairment is affected by many factors,such as the previous use of ototoxic drugs,maternal perinatal infection,hyperbilirubinemia,maternal disease during pregnancy,adverse living habits during maternal pregnancy,adverse social environmental factors during maternal pregnancy,family history of positive deafness,neonatal asphyxia and so on.