山东大学耳鼻喉眼学报 ›› 2018, Vol. 32 ›› Issue (5): 37-40.doi: 10.6040/j.issn.1673-3770.0.2017.205

• ·论著· • 上一篇    下一篇

69例梅尼埃病伴耳鸣的发病特点及影响因素

侯小兵1,任同力2,张毅博2   

  1. 1. 南京中医药大学江阴附属医院 江阴市中医院耳鼻喉科, 江苏 江阴 214400;
    2. 复旦大学附属眼耳鼻喉科医院耳科, 上海 200031
  • 收稿日期:2017-05-11 出版日期:2018-09-20 发布日期:2018-09-20
  • 通讯作者: 侯小兵. E-mail: hxb3689@126.com

Characteristics of tinnitus and the related influencing factors in patients with Menieres disease

HOU Xiaobing1, REN Tongli2, ZHANG Yibo2   

  1. Department of Otology, Fudan University Eye &ENT Hospital, Shanghai 200031, China
  • Received:2017-05-11 Online:2018-09-20 Published:2018-09-20

摘要: 目的 分析梅尼埃病患者的耳鸣特点和相关影响因素。 方法 2012年8月~2016年8月诊治的69例梅尼埃病患者,收集每位患者的纯音听阈、耳鸣患侧、持续时间、睡眠质量,采用耳鸣残障量表(THI)、眩晕残障程度评定量表(DHI)(中文版)评分。 结果 (1) 耳鸣主调频率为低频者31例,中频15例,高频23例。耳鸣响度<10 dB(SL)、10~14 dB(SL)、≥15 dB(SL)分别为41例、18例、10例;持续性耳鸣患者60例,间歇性耳鸣9例;一侧耳鸣患者58例,双侧耳鸣患者11例;(2) 伴有持续性耳鸣(t=3.099,P=0.008),睡眠质量较差(t=2.987, P=0.012),耳鸣响度较大(F=3.356,P=0.013)的患者其THI评分高于间断性耳鸣、睡眠质量较好、耳鸣响度较小的患者;(3) 多元线性回归分析结果显示,耳鸣发作频率、病程、平均听阈与DHI评分呈正相关。 结论 梅尼埃病患者伴随的耳鸣特点主要为持续低频性耳鸣。耳鸣的严重程度与耳鸣的响度、持续时间、睡眠质量有关。梅尼埃病患者性别、年龄、耳侧、双温试验对DHI评分无影响,但发作频率、持续时间、平均听阈均为影响评分的主要因素,发作频率越高的患者,其眩晕感觉越重。

关键词: 耳鸣, 梅尼埃病, 眩晕, 影响因素

Abstract: Objective To discuss and analyze the characteristics of tinnitus and the related influencing factors in patients with Menieres disease. Methods A total of 69 patients with Menieres disease were enrolled in our hospital from August 2012 to August 2016, and the pure hearing threshold, tinnitus ipsilateral, course of disease, and sleep quality of the patients were determined. The tinnitus handicap inventory(THI)scale and the dizziness handicap inventory(DHI)scale were used. Results (1) Thirty-one cases showed a low frequency of tinnitus, 15 cases showed a median frequency of tinnitus, and 23 cases showed a high frequency of tinnitus. Tinnitus loudness <10 dB(SL), 10~14 dB(SL), and ≥15 dB(SL)was noted in 41, 18, and 10 cases, respectively; 60 cases showed persistent tinnitus while 9 showed non-persistent tinnitus. Forty-eight patients had no sleep disorders and 21 had sleep disorders. (2) Patients with persistent tinnitus(t=3.099, P=0.008), poor sleep quality(F=2.987, P=0.012), and high tinnitus loudness(F=3.356, P=0.013)had higher THI scores than those with intermittent tinnitus, better sleep quality, and low tinnitus loudness. The THI scores of patients with unilateral tinnitus were lower than those of patients with bilateral tinnitus. (3) Seizure frequency, duration, and average thresholds were positively correlated with the DHI score in multiple linear regression analysis. Conclusion The primary characteristic of tinnitus accompanied by Meniere's disease is low-frequency tinnitus. The severity of tinnitus shows some relationship with tinnitus loudness, duration, and sleep quality. Sex, age, ear, and bimodal test results have no effect on the DHI score, but the onset frequency, duration, and average hearing threshold are the main factors affecting the score. The higher the frequency of the patients, the more severe the dizziness will be.

Key words: Meni disease, Dizziness, Related factors, Tinnitus

中图分类号: 

  • R764
[1] 王庆林, 郭向东, 梅祥胜, 等. 鼓室注射庆大霉素与地塞米松治疗难治性梅尼埃病的疗效分析[J]. 临床耳鼻咽喉头颈外科杂志,2017,31(2):96-99.
[2] 杨凤, 宋任东, 刘伟, 等. 外后半规管阻塞伴内淋巴囊减压治疗顽固性梅尼埃病外科技术探讨[J]. 临床耳鼻咽喉头颈外科杂志,2017,31(2):127-129.
[3] 张祎, 李云, 刘博,等. 梅尼埃病的耳鸣特征与影响因素分析[J]. 中华耳科学杂志,2016,14(2):153-157. ZHANG Yi, LI Yun, LIU Bo, et al. Characteristics and contributing factors of tinnitus in patients with Menieres disease[J]. Chin J Otol, 2016, 14(2):153-157.
[4] 陈晓鸿, 吴子明, 张素珍, 等. 梅尼埃病患者耳鸣疗效分析[J]. 中国听力语言康复科学杂志,2012,10(4):259-262. CHEN Xiaohong, WU Ziming, ZHANG Suzhen, et al. The treatment outcome of tinnitus in patients with Ménières diseas[J]. Chin Sci J Hearing Speech Rehab, 2012, 10(4):259-262.
[5] Roberts DS, Otto S, Chen B, et al. Tinnitus suppression after auditory brainstem implantation in patients with Neurofibromatosis Type-2[J]. Otol Neurotol, 2017, 38(1):118-122.
[6] Kreuzer PM, Poeppl TB, Bulla J, et al. A proof-of-concept study on the combination of repetitive transcranial magnetic stimulation and relaxation techniques in chronic tinnitus[J]. J Neural Transm(Vienna), 2016, 123(10):1147-1157.
[7] Reid SA, Callister R, Katekar MG, et al. Utility of a brief assessment tool developed from the Dizziness Handicap Inventory to screen for Cervicogenic dizziness: a case control study[J]. Musculoskelet Sci Pract, 2017, 30(1):42-48.
[8] 菅慧蓉, 于刚, 陈刚, 等. 梅尼埃病患者眩晕程度的影响因素分析[J]. 现代仪器与医疗,2017,23(1):60-62. JIAN Huirong, YU Gang, CHEN Gang, et al. Analysis of the factors affecting the degree of vertigo in patients with Menieres disease[J]. Modern Inst Med Treat, 2017, 23(1):60-62.
[9] 邹静. 钆增强 MRI 检测内淋巴积水的研究进展[J]. 听力学及言语疾病杂志,2017,25(1):75-85.
[10] 丁玉静, 刘俊秀, 马芙蓉. 内淋巴积水动物模型研究进展[J]. 中华耳科学杂志,2017,15(1):99-104. DING Yujing, LIU Junxiu, MA Furong. Research progress in animal models of endolymphatic hydrops[J]. Chin J Otol, 2017, 15(1):99-104.
[11] Havia M, Kentala E, Pyykko I. Hearing loss and tinnitus in Me-nieres disease[J]. Auris Nasus Larynx, 2002, 29(2):115-119.
[12] Romero Sánchez I, PérezGarrigues H, Rodríguez Rivera V. Clinicalcharacteristics of tinnitus in Ménières disease[J]. Acta Otorhinolaryngol Esp, 2010, 61(5):327-331.
[13] Stephens D, Pyykkö I, Yoshida T, et al. The consequences of tinnitusin long-standing Menieres disease[J]. Auris Nasus Larynx, 2012, 39(5):469-474.
[14] Pan T, Zhao Y, Ding YJ, et al. The pilot study of type Ⅰ allergic reaction in Menieres disease patients[J]. Chin J Otorhinolaryngol Head Neck Surg, 2017, 52(2): 89-92.
[15] 严进, 成红政, 刘爱国. 梅尼埃病患者前庭内淋巴积水程度与其症状和听觉及前庭功能的相关性分析[J]. 听力学及言语疾病杂志, 2015(3):220-225. YAN Jin, CHENG Hongzheng, LIU Aiguo. The correlation analysis of endolymphatic hydrops degree in vestibule and the symptoms and audiovestibular functions in patients with Menieres disease[J]. J Audiol Speech Pathol, 2015(3):220-225.
[1] 刘冰,李蓓,张莉,陈敏,张杰. 学龄前和学龄期BPV患儿临床特征比较[J]. 山东大学耳鼻喉眼学报, 2018, 32(5): 58-60.
[2] 王坛,武珂,李连庆,宫丽丽. 皮下免疫治疗注射后出现全身不良反应的伴发因素及处理[J]. 山东大学耳鼻喉眼学报, 2018, 32(5): 71-74.
[3] 廖礼兵,刘绮明,宗凌,翟锦明,张建国. 42例耳鸣伴听觉过敏患者特征分析[J]. 山东大学耳鼻喉眼学报, 2018, 32(5): 31-36.
[4] 朱梓建,刘强. 眼震方向可转换型外侧半规管良性阵发性位置性眩晕35例临床分析[J]. 山东大学耳鼻喉眼学报, 2018, 32(5): 53-57.
[5] 黄娟,庞宇峰,龚静蓉,董玥辉. 耳鸣声学特征与扩展高频听阈的关系[J]. 山东大学耳鼻喉眼学报, 2018, 32(4): 7-10.
[6] 鄢慧琴,王豪. 难治性良性阵发性位置性眩晕的临床分析[J]. 山东大学耳鼻喉眼学报, 2018, 32(3): 86-88.
[7] 李桂芳,王春华,张淑贞. 体位限制对手法复位后良性阵发性位置性眩晕的疗效观察[J]. 山东大学耳鼻喉眼学报, 2017, 31(6): 42-45.
[8] 张玉波,岳丽艳,尹晓妍,吕哲,单春光. 耳鸣治疗仪联合银杏叶提取物注射液治疗突聋伴耳鸣的疗效分析[J]. 山东大学耳鼻喉眼学报, 2017, 31(5): 50-53.
[9] 鞠骏,李进让,邹世桢,贾曼玉. 创伤后良性阵发性位置性眩晕的临床特点及近期疗效研究[J]. 山东大学耳鼻喉眼学报, 2017, 31(5): 57-61.
[10] 张晓莉,于泓,韩冬梅,杨瑞民,戚伟. 泪道激光联合引流管植入治疗泪道阻塞的临床观察[J]. 山东大学耳鼻喉眼学报, 2017, 31(4): 84-86.
[11] 伦杰,张亚楠. 慢性鼻-鼻窦炎伴鼻息肉复发的相关影响因素分析[J]. 山东大学耳鼻喉眼学报, 2017, 31(3): 80-83.
[12] 刘旭晖,黄魏宁,孟曦曦,刘芳,陈敏,傅元,张晨,张媛媛. 梅尼埃病患者内耳内淋巴间隙的比值与正常受试者的比较[J]. 山东大学耳鼻喉眼学报, 2017, 31(2): 39-42.
[13] 刘学升,李筱瑜,邓玮. DHM阴性的非典型PSC-BPPV诊断策略探讨[J]. 山东大学耳鼻喉眼学报, 2017, 31(1): 88-90.
[14] 刘学升,李筱瑜,邓玮. 后半规管良性阵发性位置性眩晕急性发作时的临床表现[J]. 山东大学耳鼻喉眼学报, 2016, 30(6): 11-13.
[15] 朱江彬,南兵卫,陈涛, 郝宗生. 低中频下降型突发性聋听阈恢复后残留耳鸣治疗体会[J]. 山东大学耳鼻喉眼学报, 2016, 30(6): 5-7.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
No Suggested Reading articles found!