类风湿性关节炎患者的纯音测听指标对照分析

Control analysis of pure tone audiometry indexes in patients with rheumatoid arthritis

目的:分析类风湿性关节炎(rheumatoidarthritis,RA)患者的纯音测听指标,研究其听觉损害特征,寻找可能的干预方法。方法:对57例RA患者进行纯音听阈测定,并与正常对照组进行比较。结果:RA组检出听力减退患者31例,患病率54%,而63例对照组仅检出18例,患病率为29%,前者显著高于后者(χ2=8.254,P<0.01)。RA组的语言频率犤左(18.1±5.6)dB和右(21.9±8.7)dB犦,4kHz频率犤左(26.3±9.6)dB和右(27.4±8.8)dB犦和8kHz频率犤左(33.2±11.5)dB和右(32.7±12.3)dB犦等纯音测听指标均明显高于对照组(t=1.965～2.217,P均<0.05)。按病程分组后,病程长组的各个频率双侧纯音测听指标均显著高于对照组(t=2.092～2.255,P均<0.05)。病情分组后,病情重组(22例)的各个频率双侧纯音测听指标均明显高于病情轻组(35例)(t=2.046～2.273,P均<0.05)。按Fries功能障碍指数分组后,功能差组(19例)的多数频率纯音测听指标(语言频率右侧和8kHz右侧除外)均明显高于功能佳组(38例)(t=2.036～2.272,P均<0.05)。结论:RA患者有很高的听力减退患病率,其患病率常与病程、病情分期和功能障碍程度密切相关,对于这一群体应注意监测听力。

AIM: To analyze the pure tone audiometry indexes in patients with rheumatoid arthritis(RA), and to study the characters of hearing loss and seek the feasibility of intervention. METHODS: Pure tone audiometry was performed in 57 patients with RA, and the results were compared with 63 normal controls. RESULTS: Sensorineural hearing loss was found in 31 cases, and the prevalence rate was 54%in the RA group, significantly higher than those in the control group(18 cases,29%)(χ2=8.254,P< 0.01).Speech frequency [left(18.1±5.6)dB,right(21.9±8.7) dB],4 kHz [left (26.3±9.6)dB, right (27.4±8.8)dB] and 8 kHz [left (33.2±11.5)dB,right(32.7±12.3)dB] in the RA group were significantly higher than those in the control group(t=1.965-2.217,P< 0.05).After grouping according to diseases course,pure tone audiometry indexes in long lasting group at various frequencies of bilateral ears were all significantly higher than those in the control group(t=2.092-2.255,P< 0.05).After grouping according to state of illness,pure tone audiometry indexes in the severe group(22 cases) at various frequencies were significantly higher than those in the light group(35 cases)(t=2.046-2.273,P< 0.05).After grouping according to Fries function disability index, most pure tone audiometry indexes(except speech frequency and 8 kHz of right ear) in the severe disability group(19 cases) were obviously higher than those in the light disability group(38 cases)(t=2.036-2.272,P< 0.05).The prevalence rate of hearing loss in the patients with RA is higher than the controls,which is closely associated with disease courses, diagnosis and disability levels,so audiometry of the patients with RA should be monitored.