山东大学耳鼻喉眼学报 ›› 2025, Vol. 39 ›› Issue (1): 1-7.doi: 10.6040/j.issn.1673-3770.0.2023.384

• 论著 •    

慢性主观性耳鸣患者心理特征、睡眠质量调查及与临床效果相关性

郭振平1,2,3,李雪冰1,2   

  1. 1.中国科学院 心理研究所, 北京 100101;
    2.中国科学院大学 心理学系, 北京 100049 ;
    3.清华大学附属北京清华长庚医院/清华大学临床医学院 耳鼻咽喉头颈外科, 北京 102218
  • 发布日期:2025-01-17
  • 通讯作者: 李雪冰. E-mail: mufurong5452@163.com

A survey of the psychological characteristics, sleep quality, and correlation with clinical outcomes in patients with chronic subjective tinnitus

GUO Zhenping1,2,3, LI Xuebing1,2   

  1. 1. Institute of psychology, Chinese Academy of Sciences, Beijing 100101, China2. Department of Psychology, University of Chinese Academy of Sciences, Beijing 100049, China3. Department of Otorhinolaryngology & Head and Neck Surgery, Beijing Tsinghua Changgung Hospital/School of Clinical Medicine, Tsinghua University, Beijing 102218, China
  • Published:2025-01-17

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摘要： 目的 探讨慢性主观性耳鸣(chronic subjective tinnitus, CST)患者的心理特征及睡眠质量,并分析其与临床效果的相关性。 方法 选入CST患者80例,采用抑郁自评量表(self-rating depression scale, SDS)、焦虑自评量表(self-rating anxiety scale, SAS)、匹兹堡睡眠质量指数(Pittsburgh sleep quality index, PSQI)评价患者的心理特征及睡眠质量,同时给予常规药物治疗,分析临床效果与心理特征及睡眠质量的相关性。 结果 随着听力下降程度加重,患者治疗前THI-C(F=28.255,P<0.001)、SDS(F=316.139,P<0.001)、SAS(F=204.933,P<0.001)、PSQI量表评分(F=220.602,P<0.001)均显著增加。正常听力与轻度聋(P=0.186),重度聋与极重度聋(P=0.09)患者中文版耳鸣残疾量表(Chinese version of the tinnitus handicap disability version, THI-C)评分比较无统计学意义,其他各听力程度组间均有统计学意义(P均<0.001)。高频耳鸣患者治疗前THI-C、SDS、SAS、PSQI量表评分显著高于低频和中频患者,中频患者则显著高于低频患者(F=48.950,P<0.001;F=225.048,P<0.001;F=230.489,P<0.001;F=332.730,P<0.001)。重度耳鸣患者治疗前SDS、SAS和PSQI量表评分显著高于轻度和中度患者,中度患者则显著高于轻度患者(P均<0.001)。治疗前THI-C评分与SDS、SAS和PSQI量表评分均有显著正相关性(r=0.649、0.681和0.657,P均<0.001)。80例患者治疗总有效率为63.75%,其中治愈21例、显效30例。患者治疗后THI-C(t=7.605,P<0.001)、SDS(t=25.344,P<0.001)、SAS(t=26.801,P<0.001)和PSQI量表评分(t=38.171,P<0.001)均显著低于治疗前,差异有统计学意义。治愈患者SDS(F=374.158,P<0.001)、SAS(F=577.547,P<0.001)和PSQI量表评分(F=570.382,P<0.001)显著低于显效和无效患者,显效患者则显著低于无效患者。 结论 CST患者存在普遍的抑郁、焦虑等负性情绪,睡眠质量较差,且其负性情绪和睡眠质量与耳鸣、听力程度有密切相关性,可对治疗效果造成不良影响。

关键词: 慢性主观性耳鸣, 心理特征, 睡眠质量, 临床效果, 相关性

Abstract: Objective This study aims to not only explore the psychological characteristics and sleep quality of patients with chronic subjective tinnitus(CST)but also analyze their correlation with clinical outcomes. Methods Eighty patients with CST were selected. The psychological characteristics and sleep quality of the patients were evaluated using the Self-Rating Depression Scale(SDS), Self-Rating Anxiety Scale(SAS), and pittsburgh sleep quality index(PSQI). Routine drug treatment was also given to analyze the correlation between clinical efficacy and psychological characteristics and sleep quality. Results As the degree of hearing loss worsens, the SDS, SAS, and PSQI scores of patients before treatment all significantly increase(F=28.255, P<0.001; F=31.613 9, P<0.001; F=204.933, P<0.001; F=220.602, P<0.001). There was no statistically significant differencein the scores of the Chinese version of the tinnitus handicap disability version(THI-C)between patients with normal hearing and mild hearing loss(P=0.186), as well as between patients with severe and extremely severe hearing loss(P=0.09). The THI-C, SDS, SAS, and PSQI scores of high-frequency tinnitus patients before treatment were significantly higher than those of low-frequency and intermediate frequency patients, while intermediate frequency patients were significantly higher than those of low-frequency patients(F=48.950, P<0.001; F=225.048, P<0.001; F=230.489, P<0.001; F=332.730, P<0.001). The SDS, SAS, and PSQI scores of patients with severe tinnitus before treatment were significantly higher than those of mild and moderate patients, while moderate patients were significantly higher than mild patients(P<0.001 for all). The THI-C score before treatment was significantly positively correlated with SDS, SAS, and PSQI scale scores(r=0.649, 0.681, and 0.657, respectively, P<0.001). The total effective rate of treatment for 80 patients was 63.75%, of which 21 were cured and 30 showed significant improvement. The THI-C, SDS, SAS, and PSQI scores of the patients after treatment were significantly lower than before treatment, and the differences were statistically significant(t=7.605, P<0.001; t=25.344, P<0.001; t=26.801, P<0.001; t=38.171, P<0.001). The SDS, SAS, and PSQI scores of cured patients were significantly lower than those of significantly improved and ineffective patients, while significantly improved patients were significantly lower than ineffective patients(F=374.158, P<0.001; F=577.547, P<0.001; F=570.382, P<0.001). Conclusion Patients with CST have common negative emotions such as depression and anxiety, and their sleep quality is poor. Their negative emotions and sleep quality are closely related to tinnitus and hearing levels, which can have adverse effects on the treatment effect.

Key words: Chronic subjective tinnitus, Psychological feature, Sleep quality, Clinical effects, Relevance

中图分类号: 

  • R764.45
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