纳入社区管理的糖尿病患者听功能调查与分析

Investigation and analysis of hearing function in community-managed patients with diabetes

目的对纳入社区管理的糖尿病患者进行糖尿病耳病知晓率调查及听力评估,分析糖尿病患者听力损失特点,为将听力保健纳入社区糖尿病管理提供科学依据。方法2018~2020年北京某社区管理的719例(1438耳)糖尿病患者,对其进行问卷调查、病史采集、专科查体、听力学检查。对结果进行统计学分析。结果(1)糖尿病患者听力损失知晓率为32.5%(234/719),纯音听力检查后发现听力损失者占94.7%(1362/1438);在主诉听力正常的954耳中,92.8%(885/954)有不同程度的听力损失。(2)中青年组(438耳)中听力损失者占89.7%(393/438),其中高频听力损失者占80.6%(353/438);在主诉听力正常的334耳中,有88.0%(294/334)出现不同程度的听力损失。(3)病程≥10年糖尿病患者听力损失程度高于病程<10年者(P<0.05)。合并高血压和(或)高脂血症的糖尿病患者听力损失程度更重(P<0.05)。结论糖尿病患者听力损失自察率低,发生率高,尤其是中青年患者。糖尿病病程及合并共病是听力损失发展的危险因素,应引起医患双方的关注。

OBJECTIVE To investigate the awareness rate of diabetic otology diseases and evaluate hearing in patients with diabetes under community management,analyze the characteristics of hearing loss in patients with diabetes,and provide scientific basis for incorporating hearing care into community diabetes management.METHODS From 2018 to 2020,719 patients(1438 ears)with diabetes in a community in Beijing were investigated by questionnaire,medical history collection,specialist physical examination and audiology examination.The results were analyzed statistically.RESULTS 1.The awareness rate of hearing loss was 32.5%(234/719)in patients with diabetes,94.7%(1362/1438)reported hearing loss after pure tone hearing examination.Of the 954 ears that reported normal hearing,92.8%(885/954)were found to have varying degrees of hearing loss.2.In the young and middle-aged group(438 ears),89.7%(393/438)had hearing loss,and 80.6%(353/438)had high-frequency hearing loss.Of the 334 ears with normal hearing,88.0%(294/334)had some degree of hearing loss.3.Hearing loss was more severe in patients with diabetes with a disease duration≥10 years than patients with a disease duration<10 years(P<0.05).The degree of hearing loss was more severe in patients with diabetes with hypertension and/or hyperlipidemia(P<0.05).CONCLUSION The self-examination rate of hearing loss in patients with diabetes is low and the incidence is high,especially in young and middle-aged patients.The course and comorbidities of diabetes are risk factors for the development of hearing loss,which should be paid attention to by both doctors and patients.