The Effect of a High-Frequency-Hearing-Threshold Weighted Value on the Diagnosis of Occupational-Noise-Induced Deafness

Objective: In order to provide a theoretical basis for the revision of the current diagnostic criteria for occupational noise-induced deafness (ONID), we evaluated the degree of ONID by analyzing different high-frequency-hearing- threshold-weighted values (HFTWVs). Methods: A retrospective study was conducted to evaluate the diagnosis of patients with ONID from January 2016 to January 2017 in Guangdong province, China. Based on 3 hearing tests (each interval between the tests was greater than 3 days), the minimum threshold value of each frequency was obtained using the 2007 edition’s diagnostic criteria for ONID. The speech frequency and the HFTWVs were analyzed based on age, noise exposure, and diagnostic classi-fication using SPSS21.0. Results: 168 patients in total were involved in this study, 154 males and 14 females, and the average age was 41.18 ± 6.07. The diagnosis rate was increased by the weighted value of the high frequencies and was more than the mean value of the pure speech frequency (MVPSF). The diagnosis rate for the weighted 4 kHz frequency level increased by 13.69% (χ2 = 9.880, P = 0.002), the weighted 6 kHz level increased by 15.47% (χ2 = 9.985, P = 0.002), and the weighted 4 kHz + 6 kHz level increased by 15.47% (χ2 = 9.985, P = 0.002). The differences were all statistically significant. The diagnostic rate of the different thresholds showed no obvious difference between the genders. The age groups were divided into less than or equal to 40 years old (group A) and 40 - 50 years old (group B). There were several groups with a high frequency: high frequency weighted 4 kHz ( group A χ2 = 3.380, P = 0.050;group B χ2 = 4.054, P = 0.032), high frequency weighted 6 kHz (group A χ2 = 6.362, P = 0.012;group B χ2 = 4.054, P = 0.032), weighted 4 kHz + 6 kHz (group A χ2 = 6.362 P = 0.012;B χ2 = 4.054, P = 0.032) than those of MVPSF in the same group on ONID diagnosis rate. The differences between the groups were statistically significant. There was no significant difference between the age groups (χ2 = 2.265, P = 0.944). The better ear’s (the smaller hearing threshold weighted value) MVPSF and the weighted values for the different high frequencies were examined in light of the number of working years;the group that was exposed to noise for more than 10 years had significantly higher values than those of the average thresholds of each frequency band in the groups with 3 - 5 years of exposure (F = 2.271, P = 0.001) and 6 - 10 years of exposure (F = 1.563, P = 0.046). The differences were statistically significant. The different HFTWVs were higher than those of the MVPSF values, and the high frequency weighted 4 kHz + 6 kHz level showed the greatest difference, with an average increase of 2.83 dB. The diagnostic rate that included the weighted high frequency values was higher for the mild, moderate, and severe cases than those patients who were only screened with the pure frequency tests. The results of the comparisons of the diagnosis rates for mild ONID were as follows: the weighted 3 kHz high frequency level (χ2 = 3.117, P = 0.077) had no significant difference, but the weighted 4 kHz level (χ2 = 10.835, P = 0.001), 6 kHz level (χ2 = 9.985, P = 0.002), 3 kHz + 4 kHz level (χ2 = 6.315, P = 0.012), 3 kHz + 6 kHz level (χ2 = 6.315, P = 0.012), 4 kHz + 6 kHz level (χ2 = 9.985, P = 0.002), and 3 kHz + 4 kHz + 6 kHz level (χ2 = 7.667, P = 0.002) were significantly higher than the diagnosis rate of the mean value of the PSF. There was no significant difference between the 2 groups for the moderate and severe grades (P > 0.05). Conclusion: Different HFTWVs increase the diagnostic rate of ONID. The weighted 4 kHz, 6 kHz, and 4 kHz + 6 kHz high frequency values greatly affected the diagnostic results, and the weighted 4 kHz + 6 kHz high frequency hearing threshold value has the maximum the effect on the ONID diagnosis results.

中文版hearWHO应用程序在听力筛查中的验证

目的验证中文版hearWHO应用程序,一款噪声下数字言语测试工具,在听力筛查中的有效性。方法招募听力正常者12名,听力损失患者92例。所有受试者依次完成纯音听阈测试、声导抗测试以及中文版hearWHO测试。分析双耳PTA0.5~4kHz和hearWHO得分的相关性,采用受试者工作特性曲线及曲线下面积等参数,确定hearWHO得分在最佳诊断截点下的灵敏度和特异度。结果hearWHO得分与较好耳和较差耳纯音听阈均值PTA0.5~4kHz均呈显著负相关性,相关系数分别为-0.552和-0.693(P<0.001)。按PTA0.5~4kHz≥20dBHL为存在听力损失的标准,当hearWHO得分≤60时,提示至少单耳出现听力下降,灵敏度和特异度分别为0.733、0.690;当hearWHO得分≤50时,提示受试者可能存在双耳听力下降,灵敏度和特异度分别为0.815、0.917。结论hearWHO对检出单耳或双耳听力损失的灵敏度和特异度均较高,当hearWHO得分≤60时,提示受试者有必要转诊进行进一步的听力检测及诊断。

Age-related hearing loss accelerates the decline in fast speech comprehension and the decompensation of cortical network connections

Patients with age-related hearing loss face hearing difficulties in daily life.The causes of age-related hearing loss are complex and include changes in peripheral hearing,central processing,and cognitive-related abilities.Furthermore,the factors by which aging relates to hearing loss via changes in audito ry processing ability are still unclear.In this cross-sectional study,we evaluated 27 older adults(over 60 years old) with age-related hearing loss,21 older adults(over 60years old) with normal hearing,and 30 younger subjects(18-30 years old) with normal hearing.We used the outcome of the uppe r-threshold test,including the time-compressed thres h old and the speech recognition threshold in noisy conditions,as a behavioral indicator of auditory processing ability.We also used electroencephalogra p hy to identify presbycusis-related abnormalities in the brain while the participants were in a spontaneous resting state.The timecompressed threshold and speech recognition threshold data indicated significant diffe rences among the groups.In patients with age-related hearing loss,information masking(babble noise) had a greater effect than energy masking(speech-shaped noise) on processing difficulties.In terms of resting-state electroencephalography signals,we observed enhanced fro ntal lobe(Brodmann’s area,BA11) activation in the older adults with normal hearing compared with the younger participants with normal hearing,and greater activation in the parietal(BA7) and occipital(BA19) lobes in the individuals with age-related hearing loss compared with the younger adults.Our functional connection analysis suggested that compared with younger people,the older adults with normal hearing exhibited enhanced connections among networks,including the default mode network,sensorimotor network,cingulo-opercular network,occipital network,and frontoparietal network.These results suggest that both normal aging and the development of age-related hearing loss have a negative effect on advanced audito ry processing capabilities and that hearing loss accele rates the decline in speech comprehension,especially in speech competition situations.Older adults with normal hearing may have increased compensatory attentional resource recruitment represented by the to p-down active listening mechanism,while those with age-related hearing loss exhibit decompensation of network connections involving multisensory integration.

EFFECTS OF MODERATE NOISE EXPOSURE ON HEARING FUNCTION IN C57BL/6J MICE

Objective To study characteristics of hearing loss after exposure to moderate noise exposure in C57BL/6J mice. Methods Male C57BL/6J mice with normal hearing at age of 5-6 weeks were chosen for this study. The mice were randomly sclccted to be studied immediately after exposure （Group P0）, or 1 day （Group P1）, 3 days （Group P3）, 7 day （Group P7） or 14 days （P14） after exposure. Their before exposure condition served as the normal control. All mice were exposed to a broad-band white noise at 100 dB SPL for 2 hours, ABR thresholds were used to estimate hearing status at each time point. Results ABR threshold elevation was seen at every tested frequency at P0 （P〈0.01）. Elevation at high-frequencies （16 kHz and 32 kHz） was greater than at lower frequencies （4 kHz and 8 kHz, P〈0.05）. From P1 to P14, ABR thresholds continuously improved, and there was no significant difference between P14 and before exposure （P〉0.05）. Conclusion There is a frequency specific re- sponse to 100 dB SPL broad-band white noise in C57BL/6J mice, with the high-frequency being more susceptible. Hearing loss induced by moderate noise exposure appears reversible in C57BL/6J mice.

The comparison of auditory behavioral and evoked potential responses (steadystate and cortical) in subjects with occupational noise-induced hearing loss

Objective: To define difference scores between PTA, ASSR and CERA thresholds in subjects with occupational NIHL.Design: 44 subjects undergoing a medico-legal expert assessment for occupational NIHL and fulfillingcriteria of reliability were considered. Assessment included: PTA, 40 Hz binaural multiple ASSR and CERA(1-2-3 kHz).Results: The respective average difference scores (ASSR - PTA) for 1, 2 and 3 kHz are 13.01 (SD 10.19) dB,12.72 (SD 8.81) dB and 10.38 (SD 8.19) dB. The average (CERA - ASSR) difference scores are 1.25 (SD 14.63)dB for 1 kHz (NS), 2.73 (SD 13.03) dB for 2 kHz (NS) and 4.51 (SD 12.18) dB for 3 kHz. The correlationbetween PTA and ASSR (0.82) is significantly stronger than that between PTA and CERA (0.71). In a givensubject, PTA thresholds are nearly always lower (i.e., better) than ASSR thresholds, whatever the frequency (1-2-3 kHz) and the side (right e left). A significant negative correlation is found between thedifference score (ASSR e PTA) and the degree of hearing loss.Conclusion: ASSR outperforms CERA in a medicolegal context, although overestimating the behavioralthresholds by 10e13 dB.

Detection of Early Noise-Induced Hearing Impairment in Pilots

Objective To detect early signs of noise-induced hearing loss(NIHL) in military pilots without hearing complaints. Methods Pure tone audiometry and acoustic reflex thresholds were tested in 36 military pilots (72 ears) with noise exposure history but no complaints of hearing loss. Conventional test frequencies (0.25-8 kHz) and extended high frequencies (EHF, 10 and 12.5 kHz) were included in audiometry. White noise and pure tones at 0.5, 1, 2, and 4 kHz were used for acoustic reflex tests. Twenty normal hearing subjects(40 ears) with no exposure to occupational noise were used as controls. Results Pure tone thresholds at all conventional frequencies and at EHFs were elevated in the pilots, with the maximum shift at 4 kHz, compared with controls (p < 0.01). The pilots also showed elevated ART to white noise and decreased differentials between white noise and pure tone ARTs (p< 0.01). Conclusion Early signs of NIHL are present in some symptom-free military pilots. High frequency hearing threshold shift, elevated white noise ART and decreased differential between white noise and pure tone ARTs may be objective indicators of early NIHL.

Context Dependent Auditory Thresholds Determined by Brainstem Audiometry and Prepulse Inhibition in Mongolian Gerbils

Information on hearing thresholds is not always reliable as differences in these thresholds have been described even for the same species. This may partially be due to different methods used by different labs. A frequently used approach to obtain an estimate of hearing threshold is the electrophysiological recording of auditory brainstem responses (ABR). They are usually recorded under deep anesthesia and represent the auditory evoked far-field potentials at various levels in the central auditory pathway. Alternatively, several behavioral approaches are employed. These commonly use operant or classical conditioning to determine hearing thresholds. A potential disadvantage of these methods is that any sound conditioning may in principle alter auditory perception and therefore auditory thresholds. To exclude this type of methodological bias a prepulse inhibition (PPI) paradigm can be used where an audiogram can be determined without any kind of pre-training. Here we compare the threshold estimates obtained by two different ABR and PPI measurements where stimuli are presented in different contexts, either randomly or non-randomly, to test for a possible effect of auditory sensitization. In addition we test the effect of a frequency specific acoustic trauma on the audiograms obtained with both methods. In general we find behaviorally determined audiograms to be significantly lower in absolute thresh- old compared to ABR measurements. Furthermore non-randomized presentation context of the stimuli generally results in audiograms with 10 to 15 dB lower thresholds than pseudo-randomized presentation. Finally, the amount of threshold loss induced by acoustic trauma is similar for all methods tested.

Impairment of extra-high frequency auditory thresholds in subjects with elevated levels of fasting blood glucose

This study was performed to assess whether there is an association between elevated Fasting Blood Glucose(FBG) and hearing impairment in Bangladeshi population. A total of 142 subjects(72 with elevated FBG; 70 control) were included in the study. The mean auditory thresholds of the control subjects at 1,4,8 and 12 kHz frequencies were 6.35 ± 0.35,10.07 ± 0.91,27.57 ± 1.82, 51.28 ± 3.01 dB SPL(decibel sound pressure level), respectively and that of the subjects with elevated FBG were 8.33 ± 0.66,14.37 ± 1.14, 38.96 土 2.23, and 71.11 ± 2.96 dB.respectively. The auditory thresholds of the subjects with elevated FBG were significantly(p < 0.05) higher than the control subjects at all the above frequencies, although hearing impairment was most evidently observed at an extra-high(12 kHz) frequency. Subjects with a long duration of diabetes(>10 years) showed significantly(p < 0.05) higher level of auditory thresholds at 8 and 12 kHz, but not at 1 and 4 kHz frequencies,compared to subjects with shorter duration of diabetes(≤10 years). In addition, based on the data of odds ratio, more acute impairment of hearing at the extra-high frequency was observed in diabetic subjects of both older(>40 years) and younger(<40 years) age groups compared to the respective controls. The binary logistic regression analysis showed a 5.79-fold increase in the odds of extra-high frequency hearing impairment in diabetic subjects after adjustment for age, gender and BMI. This study provides conclusive evidence that auditory threshold at an extra-high frequency could be a sensitive marker for hearing impairment in diabetic subjects.

成人CE-Chirp ABR反应阈与纯音听阈相关分析与比较

目的 采用听神经同步专利刺激声(CE-Chirp声)对成人听性脑干反应(auditory brainstem response,ABR)进行测试,分析CE-Chirp ABR测试的V波反应阈与纯音听阈的关系,研究CE-Chirp声在法医学鉴定听觉功能障碍评估中的作用。方法 选择常州市德安医院2018年1月—2019年6月进行CE-Chirp ABR测试的受试者(年龄为20~77周岁,共计100耳),获得V波反应阈值,并在0.5、1.0、2.0、4.0 kHz分别进行纯音气导听阈测试,获得纯音听阈值,按照不同听力水平及不同年龄对受试者进行分组。比较不同听力水平及不同年龄组平均纯音听阈与V波反应阈之间的差值及统计学差异;对所有受试者各频率两种方法之间的相关性、差值及统计学差异进行分析;建立所有受试者CE-Chirp ABR V波反应阈推断纯音听阈的线性回归方程,并检验其推断纯音听阈的可行性。结果 不同听力水平及不同年龄组各组之间CE-Chirp ABR反应阈与纯音听阈差值的差异无统计学意义(P>0.05);各频率成人CE-Chirp ABR V波反应阈与纯音听阈之间相关性良好,两者之间差异具有统计学意义(P<0.05),线性回归分析显示两者之间有线性相关关系(P<0.05)。结论 运用CE-Chirp ABR Ⅴ波反应阈在一定条件下能够评估受试者的纯音听阈,可以作为一种听力学测试方法用于法医学听觉障碍评估。

人工耳蜗植入术中残余听力保护的研究

目的通过比较有残余听力的患者人工耳蜗植入(cochlear implantation,CI)术前、术后1、2年250、500、1000、2000Hz纯音听阈均值的差异,探讨如何保护残余听力。方法纳入2020年1月至2021年12月安徽医科大学第一附属医院行CI患者32例为研究对象,通过定期随访,对患者术前、术后1、2年各频率段纯音听阈阈值进行比较,评估术后残余听力有无得到保留。结果术后大前庭导水管综合征患者出现明显眩晕症状2例,予以激素、抗眩晕等对症治疗后好转。术后1年,CI患者250、500、1000、2000 Hz纯音阈值均高于术前,差异有统计学意义(P<0.001);术后2年,CI患者2000Hz纯音阈值高于术后1年,差异有统计学意义(P<0.05),CI患者术后2年250、500、1000 Hz纯音阈值与术后1年比较,差异无统计学意义(P>0.05)。结论术中可通过“柔”手术方法,长期保留患者残余听力,使患者CI术后能很好利用残余听力。

17例耳硬化症患者的临床与影像学分析

目的分析17例耳硬化症患者的临床特征、影像学表现及手术治疗效果。方法收集2020年5月~2023年5月在湖州市中心医院接受手术治疗的17例(17耳)耳硬化症患者临床、影像学资料,分析其临床表现、颞骨CT影像学表现及手术前后纯音测听结果变化。结果17例(17耳)患者中,11耳(64.71%)为前庭窗型,表现为进行性传导性听力损失,其中9耳有耳鸣,3耳有轻微平衡问题;混合型6耳(35.29%)显示混合性听力损失,5耳有耳鸣,3耳有偶发性平衡障碍。影像学上,前庭窗型显示镫骨底板区域骨质增厚、前庭窗密度增加;混合型则显示镫骨底板增厚及耳蜗周围密度减低,1耳可见“双环征”,两种类型耳硬化症患者骨密度差异无统计学意义(P>0.05)。术后均未见耳鸣加重或其他严重并发症,仅2例(11.76%)出现暂时性头晕,术后随访显示术区恢复良好,无感染或其他迟发性并发症;术后听力测试显示气导阈值、气骨导差较术前显著改善(P均<0.05)。结论前庭窗型和混合型耳硬化症的影像学和临床表现各有特点,镫骨成形术可显著改善听力,降低气导阈值和气骨导差,且手术安全、并发症少。

耳穴贴压在血瘀耳窍型突发性耳聋患者中的应用效果

目的 研究耳穴贴压在血瘀耳窍型突发性耳聋患者中的干预效果。方法 以江苏省东台市中医院于2022年4月至2023年5月收治的116例血瘀耳窍型突发性耳聋患者为研究对象,使用随机数表法将其分别纳入观察组和对照组,各58例。2组均接受常规综合治疗,观察组加用耳穴贴压。对比2组的听力损失程度、纯音听阈、心理状态和临床疗效。结果 观察组在治疗3周后的听力损失程度较对照组而言相对更轻,且组间比较存在统计学差异(P<0.05)。2组在治疗1周和3周后的纯音听阈均较治疗前下降,观察组在治疗1周和3周后的纯音听阈均较对照组而言相对更优,且差异均存在统计学意义(P均<0.05)。2组在治疗3周后的焦虑自评量表(SAS)和抑郁自评量表(SDS)评分均较治疗前下降,观察组在治疗3周后的SAS、SDS评分均较对照组而言相对更低,且差异均存在统计学意义(P均<0.05)。观察组在治疗3周后的总有效率为93.10%,较对照组的79.31%而言相对更高,且组间比较存在统计学差异(P<0.05)。结论 针对血瘀耳窍型突发性耳聋患者的治疗加用耳穴贴压,不仅能促进患者听力的进一步恢复,还能改善其心理状态和纯音听阈,以及实现临床疗效的提高。

正常听力青年人不同刺激声下的听性脑干反应与纯音听阈测定的相关性

目的:对青年人进行纯音听阈(PTA)、短声听性脑干反应(Click-ABR)和CE-Chirp刺激声听性脑干反应(CE-Chirp-ABR)测试,分析在不同声刺激声下的听性脑干反应与PTA均值之间的关系。方法:选择30名(60耳)青年人,记录双耳0.5、1.0、2.0、4.0 kHz下PTA、Click-ABR和CE-Chirp-ABR的反应阈,分析Click-ABR和CE-Chirp-ABR反应阈与PTA均值之间的关系。结果:Click-ABR与PTA均值呈正相关(r=0.421,P<0.001);CE-Chirp-ABR的1.0、2.0、4.0 kHz与PTA均值均呈正相关(r值分别为0.312,0.359,0.390,均P<0.05),而在0.5 kHz时相关性无统计学意义(P>0.05)。结论:在低频(1.0 kHz)处,CE-Chirp-ABR比Click-ABR更具临床应用价值,而在更低频(0.5 kHz)的应用效果还需进一步研究。

慢性化脓性中耳炎患者行鼓室成形术中植入钛人工听骨链在降低听力阈值及改善听力状态中的价值

目的探讨鼓室成形术中植入钛人工听骨链降低慢性化脓性中耳炎患者听力阈值、改善听力状态的效果。方法选取河南科技大学第二附属医院耳鼻咽喉科2019年1月至2022年1月80例慢性化脓性中耳炎患者作为研究对象,随机数字表法分为对照组(40例)和植入组(40例)。对照组采取单纯鼓室成形术,进行自体听骨链重建,未植入钛人工听骨链,植入组患者在行鼓室成形术中植入钛人工听骨链,对比两组术前术后纯音听力重建水平,听力状态改善效果及并发症、复发率。结果植入组听力改善有效率高于对照组(P<0.05);术后听力阈值均较术前降低,且植入组气导听力阈值、气骨导差低于对照组(P<0.05),骨导听力阈值组间差异无统计学意义(P>0.05);两组术后并发症发生率、复发率差异无统计学意义(P>0.05)。结论在行鼓室成形术中植入钛人工听骨链能有效提升慢性化脓性中耳炎患者的听力水平,降低气导听力阈值及气骨导差,且不增加术后并发症及疾病复发风险,效果确切,值得临床应用及进一步研究。

巴曲酶联合高压氧对突发性耳聋患者的临床疗效研究

目的 研究巴曲酶联合高压氧对突发性耳聋患者的临床疗效。方法 目的选取涟水县人民医院于2020年2月—2023年6月收治的88例突发性耳聋患者为研究对象,根据治疗方法不同将患者分为对照组和研究组,各44例。对照组行常规治疗,研究组在对照组基础上给予巴曲酶注射液。对比观察两组患者临床疗效、听阈值、血流动力学指标。结果 研究组的总有效率(97.73%)高于对照组(81.82%),差异有统计学意义(χ^(2)=4.456,P<0.05)。治疗后,研究组听阈值和血流动力学指标均低于对照组,差异有统计学意义(P均<0.05)。结论 巴曲酶联合高压氧治疗可以提高突发性耳聋患者的治疗效果,恢复患者听力,并改善血流动力学指标。

银杏叶提取物联合地塞米松治疗突发性聋患者的效果

目的:观察银杏叶提取物联合地塞米松治疗突发性聋患者的效果。方法:选取2020年8月至2023年8月该院收治的82例突发性聋患者进行前瞻性研究,按照随机数字表法将其分为研究组和对照组各41例。对照组采用地塞米松治疗,研究组在对照组基础上联合银杏叶提取物治疗,比较两组临床疗效、临床症状(耳鸣耳闷、恶心呕吐、眩晕)消失时间、治疗前后纯音听阈值、氧化应激指标[内皮素(ET)、一氧化氮(NO)、可溶性血管细胞间黏附因子-1(sVCAM-1)]水平、血液流变学指标[血浆黏度(PV)、纤维蛋白原(FIB)、全血低切黏度(LBV)]水平以及不良反应发生率。结果:研究组治疗总有效率为95.12%,高于对照组的78.05%,差异有统计学意义(P<0.05);治疗后,两组1 kHz、2 kHz、4 kHz的纯音听阈值均低于治疗前,且研究组低于对照组,差异有统计学意义(P<0.05);研究组耳鸣耳闷、恶心呕吐和眩晕等临床症状消失时间均短于对照组,差异有统计学意义(P<0.05);治疗后,两组ET、sVCAM-1水平均低于治疗前,且研究组低于对照组,两组NO水平均高于治疗前,且研究组高于对照组,差异有统计学意义(P<0.05);治疗后,两组PV、FIB和LBV水平均低于治疗前,且研究组低于对照组,差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:银杏叶提取物注射液联合地塞米松治疗突发性聋患者可提高治疗总有效率,缩短临床症状消失时间,改善氧化应激指标水平,降低纯音听阈值和血液流变学指标水平,其效果优于单纯地塞米松治疗。

温胆汤加减联合倍他司汀治疗低频下降型突发性耳聋痰火郁结证临床观察

目的探讨温胆汤加减联合倍他司汀治疗低频下降型突发性耳聋(SD)痰火郁结证的临床疗效,以及对患者纯音听阈水平及血液流变学、血管内皮功能、免疫功能指标的影响。方法回顾性分析医院2019年1月至2020年12月收治的低频下降型SD痰火郁结证患者80例,按治疗方式的不同分为对照组(盐酸倍他司汀,38例)和观察组(温胆汤加减联合盐酸倍他司汀,42例),均连续治疗10d。结果观察组总有效率为92.86%,显著高于对照组的68.42%(P<0.05)。治疗后,两组患者的中医证候积分、纯音听阈水平均显著降低,且观察组显著低于对照组(P<0.05);两组患者的血液流变学指标全血黏度(低切、中切、高切)、血细胞比容、血浆黏度、血小板聚集率均显著降低,且观察组显著低于对照组(P<0.05);两组患者的超氧化物歧化酶水平均显著升高,过氧化脂质、一氧化氮水平均显著降低,且观察组均显著优于对照组(P<0.05);两组患者的免疫球蛋白A(IgA),IgG,IgM水平均显著升高,且观察组均显著高于对照组(P<0.05)。观察组和对照组患者不良反应发生率相当(7.14%比5.26%,P>0.05)。结论温胆汤加减联合倍他司汀治疗低频下降型SD痰火郁结证的临床疗效显著,可有效改善患者的纯音听阈水平,优化血管内皮功能、血液流变学、免疫功能,且安全性良好。

感音神经性听力损失患者的听觉皮质诱发电位平均阈值与言语识别阈相关性研究

目的研究感音神经性耳聋患者的听觉皮质诱发电位(CAEP)平均阈值与言语识别阈(SRT)的相关性,为临床通过客观检测预估主观言语测试阈提供参考。方法选取2023年1—7月收治的平均年龄为(31.2±22.7)岁的22例感音神经性听力损失患者,分别检测0.5、1、2、4 kHz频率处的CAEP反应阈和SRT,对结果进行相关性分析。结果Pearson相关性分析显示,CAEP平均阈值和SRT显著相关(r=0.764,P<0.01);非参数独立样本检验显示,CAEP平均阈值与SRT的相关性无耳间、性别间差异。结论CAEP平均阈值和SRT显著相关,对无法配合言语测试的患者,CAEP阈值可用于预估SRT。

职业噪声作业人员与高血压的相关性研究

目的研究职业噪声暴露对高血压患病率的影响,为保护噪声作业人群健康提供参考。方法运用重庆市职业病检测项目的数据资料,抽取重庆成年男性和女性在岗职业人群样本,对2017年1月至2022年12月随访的研究对象进行分层检验,对噪声与高血压的相关性进行多时点Cox分析。结果随访中发现,随着噪声暴露时间的增加,收缩压和舒张压随之增加,但收缩压增加与噪声暴露无关,研究对象双耳高频平均听阈在25~50 dB时,噪声暴露对高血压的影响差异有统计学意义(HR=0.122,95%CI=0.080,0.161)。结论噪声是高血压的独立危险因素,应加强对噪声作业工人的保护。

老化对语音线索感知能力的影响

目的探究老化是否是言语感知困难的独立因素,并明确老化对语音线索感知能力的影响模式。方法本研究招募了听力正常的青年组(n=10,平均年龄为24岁)和老年组(n=15,平均年龄为67岁)受试者,利用闭集中文短句(CMS)评估2组受试者在4种不同语音感知线索(“基线”条件、“基频”条件、“空间”条件、“基频+空间”条件)下的言语识别阈(SRT),通过对比4种条件下的SRT评估老化对基频线索和(或)空间线索的利用能力的影响。结果①RM-ANOVA分析显示,在“基线”、“基频”和“空间”条件下,老年组SRT均高于(差于)青年组(P值均<0.05),在“基频+空间”条件下,2组差异无统计学意义(P>0.05)。以听阈为协变量行协方差分析显示,老年组SRT在“空间”条件与青年组无显著差异(P>0.05)。②在“基频”、“空间”及“基频+空间”条件下,老年组掩蔽释放(MR)较青年组下降,但差异均无统计学意义(P值均>0.05)。结论老年人在复杂语境下的言语感知能力比青年人显著变差;但当语音同时具备基频和空间线索时,老年人仍可综合利用2种线索,从而达到与青年人相似的感知表现。排除听敏度的影响,老化显著削弱语音基频线索的感知能力,而对空间线索利用能力影响不显著。