山东大学耳鼻喉眼学报 ›› 2021, Vol. 35 ›› Issue (6): 70-76.doi: 10.6040/j.issn.1673-3770.0.2021.009

• • 上一篇    下一篇

持续性特发性耳鸣严重程度的相关因素分析

周腊梅1, 蒋雯2,3, 刘稳2, 乔月华2,3   

  1. 1. 徐州医科大学 研究生院, 江苏 徐州 221004;
    2. 徐州医科大学附属医院 耳鼻咽喉科, 江苏 徐州 221002;
    3. 徐州医科大学 人工听觉工程实验室, 江苏 徐州 221000
  • 发布日期:2021-12-10
  • 通讯作者: 刘稳. E-mail:liuwen1972@163.com
  • 基金资助:
    江苏省博士后科研资助计划(1701063B)

Analysis of factors related to the severity of persistent idiopathic tinnitus

ZHOU Lamei1, JIANG Wen2,3, LIU Wen2, QIAO Yuehua2,3   

  1. 1. Graduate School, Xuzhou Medical University, Xuzhou 221004, Jiangsu, China;
    2. Department of Otorhinolaryngology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou 221002, Jiangsu, China;
    3. Artificial Hearing Engineering Laboratory, Xuzhou Medical University, Xuzhou 221002, Jiangsu, China
  • Published:2021-12-10

PDF (PC)

398

摘要： 目的 探讨导致持续性特发性耳鸣严重程度的相关因素。 方法 分析870例持续性特发性主观性耳鸣患者的一般资料、病史、听力学结果、耳鸣匹配实验、耳鸣残疾量表、匹兹堡睡眠质量指数量表和焦虑自评量表,应用多因素Logistic回归分析研究与患者耳鸣严重程度相关的因素。 结果 (1)性别(P<0.001)、年龄(P=0.010)、耳鸣主调声频率(P=0.005)、听力损失(P=0.037)、焦虑程度(P<0.001)、睡眠状况(P<0.001)在THI分级上差异有统计学意义(P<0.05);(2)病程(P=0.053)、侧别(P=0.437)、主调声响度(P=0.120)在THI分级上差异均无统计学意义(P>0.05)。 结论 女性患者特发性耳鸣的程度较男性更为严重;低频较高频更扰人;焦虑程度和睡眠状况是影响耳鸣严重程度的因素,而病程、侧别、耳鸣主调声响度不是影响患者特发性耳鸣严重程度的因素。

关键词: 特发性耳鸣, 严重程度, 相关因素, THI量表, 听力损失

Abstract: Objective To analyze factors related to the severity of persistent idiopathic subjective tinnitus. Methods The general data, medical history, audiological results, tinnitus matching test results, tinnitus disability scale score, Pittsburgh Sleep Quality Index score, and self-rating anxiety scale score were analyzed in 870 patients with persistent idiopathic subjective tinnitus. The multivariate Logistic regression analysis was performed to elucidate factors related to the severity of tinnitus. Results (1)There were significant differences in sex(P<0.001), age(P=0.010), tinnitus frequency(P=0.005), hearing loss(P=0.037), anxiety degree(P<0.001)and sleep status(P<0.001)in THI classification. (2)There was no significant difference in course(P=0.053), side(P=0.437)and tone loudness(P=0.120)in THI classification. Conclusion The degree of idiopathic tinnitus in female patients is more serious than that in men; low frequency is more disturbing than high frequency; anxiety degree and sleep status are the factors affecting the severity of tinnitus, while the course of disease, lateral classification and tinnitus main tone loudness are not the factors affecting the severity of idiopathic tinnitus.

Key words: Idiopathic tinnitus, Severity, Related factors, Tinnitus handicap inventory scale, Hearing loss

中图分类号: 

  • R765.21
[1] 徐霞, 卜行宽, 邢光前, 等. 江苏地区老年人主观性耳鸣的流行病学调查[J]. 中华老年医学杂志, 2006, 25(7): 548-550. doi:10.3760/j: issn: 0254-9026.2006.07.025. XU Xia, BU Xingkuan, XING Guangqian, et al. An epidemiologic study on tinnitus in aged population of Jiangsu Province[J]. Chin J Geriatr, 2006, 25(7): 548-550. doi:10.3760/j: issn: 0254-9026.2006.07.025.
[2] Langguth B, Kreuzer PM, Kleinjung T, et al. Tinnitus: causes and clinical management[J]. Lancet Neurol, 2013, 12(9): 920-930. doi:10.1016/S1474-4422(13)70160-1.
[3] 杨静, 周慧芳, 杨东. 耳鸣响度、听力下降与耳鸣严重程度的关系研究[J]. 临床耳鼻咽喉头颈外科杂志, 2013,27(10): 458-460,464. doi:10.13201/j.issn.1001-1781.2013.10.007. YANG Jing, ZHOU Huifang, YANG Dong. To analyse the impact of tinnitus loudness and hearing loss on the life of tinnitus patient[J]. J Clin Otorhinolaryngol Head Neck Surg, 2013,27(10): 458-460,464. doi:10.13201/j.issn.1001-1781.2013.10.007.
[4] Holmes S, Padgham ND. “Ringing in the ears”: narrative review of tinnitus and its impact[J]. Biol Res Nurs, 2011, 13(1): 97-108. doi:10.1177/1099800410382290.
[5] Schaaf H, Eipp C, Deubner R, et al. Psychosocial aspects of coping with tinnitus and psoriasis patients. A comparative study of suicidal tendencies, anxiety and depression[J]. HNO, 2009, 57(1): 57-63. doi:10.1007/s00106-008-1800-4.
[6] Newman CW, Jacobson GP, Spitzer JB. Development of the tinnitus handicap inventory[J]. Arch Otolaryngol Head Neck Surg, 1996, 122(2): 143-148. doi:10.1001/archotol.1996.01890140029007.
[7] 潘滔, Richard Tyler, 宋昱, 等. 耳鸣对患者日常影响调查及耳鸣活动问卷的信度检验[J]. 中国耳鼻咽喉头颈外科, 2011,18(12): 667-670. doi:10.16066/j.1672-7002.2011.12.016. PAN Tao, TYLER R, SONG Yu, et al. Investigation of the influence of tinnitus to patients in their daily life and the reliability test of tinnitus activity questionnaire[J]. Chin Arch Otolaryngol-Head Neck Surg, 2011,18(12): 667-670. doi:10.16066/j.1672-7002.2011.12.016.
[8] 路桃影, 李艳, 夏萍, 等. 匹兹堡睡眠质量指数的信度及效度分析[J]. 重庆医学, 2014,43(3): 260-263. doi: 10.3969/j.issn.1671-8348.2014.03.002. LU Taoying, LI Yan, XIA Ping, et al. Analysis on reliability and validity of the Pittsburgh sleep quality index[J]. Chongqing Med, 2014,43(3): 260-263. doi: 10.3969/j.issn.1671-8348.2014.03.002.
[9] 徐建乐, 郑芸, 孟照莉, 等. 耳鸣严重程度与焦虑的相关性研究[J]. 临床耳鼻咽喉头颈外科杂志, 2012, 26(16): 729-732. doi:10.13201/j.issn.1001-1781.2012.16.012. XU Jianle, ZHENG Yun, MENG Zhaoli, et al. The relationship between tinnitus severity and anxiety[J]. J Clin Otorhinolaryngol Head Neck Surg, 2012, 26(16): 729-732. doi: 10.13201/j.issn.1001-1781.2012.16.012.
[10] 何静, 蒋斌, 梅志刚. 中枢神经可塑性变化与耳鸣发生机制研究进展[J]. 中国全科医学, 2014, 17(8): 955-959. doi:10.3969/j.issn.1007-9572.2014.08.030. HE Jing, JIANG Bin, MEI Zhigang. Plasticity changes in central nervous system and occurrence of tinnitus: research progress[J]. Chin Gen Pract, 2014, 17(8): 955-959. doi:10.3969/j.issn.1007-9572.2014.08.030.
[11] Olusanya BO, Davis AC, Hoffman HJ. Hearing loss: rising prevalence and impact published correction appears in Bull World Health Organ. 2020 Feb 1;98(2):148[J]. Bull World Health Organ, 2019, 97(10): 646-646A. doi: 10.2471/BLT.19.224683.
[12] McCormack A, Edmondson-Jones M, Fortnum H, et al. The prevalence of tinnitus and the relationship with neuroticism in a middle-aged UK population[J]. J Psychosom Res. 2014,76(1): 56-60. doi: 10.1016/j.jpsychores.2013.08.018.
[13] 陈秀兰, 秦兆冰. 性别、年龄、听力损失程度与耳鸣严重程度的关系探讨[J]. 听力学及言语疾病杂志, 2012,20(1): 26-28. doi: 10.3969/j.issn.1006-7299.2012.01.008. CHEN Xiulan, QIN Zhaobing. The impact of gender, age and hearing loss on the THI scores of patients with tinnitus[J]. J Audiol Speech Pathol, 2012,20(1): 26-28. doi: 10.3969/j.issn.1006-7299.2012.01.008.
[14] 赖仁淙, 马鑫. 耳鸣观念的文艺复兴[J]. 中华耳科学杂志, 2016, 14(2): 140-144. doi: 10.3969/j.issn.1672-2922.2016.02.002. Jen-Tsung LAI, MA Xin. Renaissance of tinnitus management [J]. Chin J Otol, 2016, 14(2): 140-144. doi: 10.3969/j.issn.1672-2922.2016.02.002.
[15] Al-Mana D, Ceranic B, Djahanbakhch O, et al. Hormones and the auditory system: a review of physiology and pathophysiology[J]. Neuroscience, 2008,153(4): 881-900. doi: 10.1016/j.neuroscience.2008.02.077.
[16] 俞晴, 宋为明, 马芙蓉, 等. 186例耳鸣患者的临床特征研究[J]. 中华耳科学杂志, 2007, 5(3): 239-243. doi:10.3969/j.issn.1672-2922. 2007.03.003. YU Qing, SONG Weiming, MA Furong, et al. Characteristics of tinnitus: an investigation of 186 patients[J]. Chin J Otol, 2007,(3), 5: 239-243. doi:10.3969/j.issn.1672-2922. 2007.03.003.
[17] 徐建乐, 郑芸, 孟照莉, 等. 耳鸣严重程度与焦虑的相关性研究[J]. 临床耳鼻咽喉头颈外科杂志, 2012,26(16): 729-732. doi:10.13201/j.issn.1001-1781.2012.16.012. XU Jianle, ZHENG Yun, MENG Zhaoli, et al. The relationship between tinnitus severity and anxiety[J]. J Clin Otorhinolaryngol Head Neck Surg, 2012,26(16): 729-732. doi:10.13201/j.issn.1001-1781.2012.16.012.
[18] Olsen US, Lello E, Nagaraj VS, et al. Factors affecting severity of tinnitus-a follow-up study of tinnitus subjects at an Ear Nose Throat clinic in Sweden[J]. Int Tinnitus J, 2013, 18(2): 115-121. doi:10.5935/0946-5448.20130013.
[19] 齐思涵, 秦兆冰, 陈秀兰, 等. 影响慢性主观性耳鸣严重程度的相关因素分析[J]. 听力学及言语疾病杂志, 2014,22(4): 367-370. doi:10.3969j/.issn.10067299.2014.04.0. QI Sihan, QIN Zhaobing, CHEN Xiulan, et al. The correlation factors of the severity of chronic subjective tinnitus[J]. J Audiol Speech Pathol, 2014,22(4): 367-370. doi:10.3969j/.issn.10067299.2014.04.0.
[20] Baguley D, McFerran D, Hall D. Tinnitus[J]. Lancet, 2013, 382(9904): 1600-1607. doi:10.1016/s0140-6736(13)60142-7.
[21] Zhang JJ, Zhang Z, Huang SJ, et al. Differences in clinical characteristics and brain activity between patients with low- and high-frequency tinnitus[J]. Neural Plast, 2020, 2020: 1-12. doi:10.1155/2020/5285362.
[22] 王梦琳, 宋昱, 马芙蓉. 纹状体参与耳鸣神经调控的研究进展[J]. 中华耳科学杂志, 2020,18(2): 363-366. doi: 10.3969/j.issn.1672-2922.2020.02.028. WANG Menglin, SONG Yu, MA Furong. Advances of research on striatum involvement in tinnitus neuromodulation[J]. Chin J Otol, 2020,18(2): 363-366. doi: 10.3969/j.issn.1672-2922.2020.02.028.
[23] Jastreboff PJ. Phantom auditory perception(tinnitus): mechanisms of generation and perception[J]. Neurosci Res, 1990, 8(4): 221-254. doi:10.1016/0168-0102(90)90031-9.
[24] 陈秀兰, 宋凡, 秦兆冰, 等. 耳鸣严重程度与焦虑、抑郁及人格特征的相关性[J]. 听力学及言语疾病杂志,2021, 29(4):1-3. doi:10.3969/j.issn.1006-7299.2021.04.020.
[25] 宋勇莉, 齐柳, 陈阳, 等. 慢性耳鸣患者合并焦虑和抑郁影响因素的分析[J]. 听力学及言语疾病杂志, 2021,29(4): 398-402. doi:10.3969/j.issn.1006-7299.2021.04.009. SONG Yongli, QI Liu, CHEN Yang, et al. Influencing factors of anxiety and depression in patients with chronic tinnitus[J]. J Audiol Speech Pathol, 2021,29(4): 398-402. doi:10.3969/j.issn.1006-7299.2021.04.009.
[26] 余力生, 马鑫. 耳鸣的代偿与失代偿[J]. 中华耳鼻咽喉头颈外科杂志, 2017, 52(8): 630-633. doi: 10.3760/cma.j.issn.1673-0860.2017.08.019. YU Lisheng, MA Xin. Compensation and decompensation of tinnitus[J]. Chinese JOurnal of Otorhinolaryngology Head and Neck Surgery, 2017, 52(8): 630-633. doi: 10.3760/cma.j.issn.1673-0860.2017.08.019.
[27] 钟萍, 卢兢哲, 郑芸, 等. 基于医师疗法理念调整生活方式对265例耳鸣患者的疗效观察[J]. 中国听力语言康复科学杂志, 2018,16(6): 430-432. doi: 10.3969/j.issn.1672-4933.2018.06.007. ZHONG Ping, LU Jingzhe, ZHENG Yun, et al. A short-term treatment efficacy study of 265 tinnitus patients intervened with lifestyle adjustment based on yi Shi therapy(YST)principles[J]. Chin Sci J Hear Speech Rehabilitation, 2018,16(6): 430-432. doi: 10.3969/j.issn.1672-4933.2018.06.007.
[1] 黄岚,高伟陈钢钢. 内耳疾病继发BPPV的发病机制和临床特征的研究进展[J]. 山东大学耳鼻喉眼学报, 2022, 36(4): 108-113.
[2] 马宁, 陈敏, 刘薇, 杨扬, 邵剑波, 郝津生, 刘冰, 张晓, 段晓岷, 张祺丰, 张杰. 儿童颞骨骨折临床特点和治疗策略[J]. 山东大学耳鼻喉眼学报, 2022, 36(1): 13-19.
[3] 胡春燕, 党攀红, 张睿, 樊孟耘. 儿童单侧感音性听力损失的听力学及影像学特征149例分析[J]. 山东大学耳鼻喉眼学报, 2022, 36(1): 31-36.
[4] 兰世鹏, 陈智斌, 曹新, 邢光前. 一个新的X连锁耳聋综合征的表型特征[J]. 山东大学耳鼻喉眼学报, 2021, 35(3): 65-69.
[5] 林宗通,沈翎,杨中婕. 腺样体大小及圆枕类型对儿童分泌性中耳炎的影响[J]. 山东大学耳鼻喉眼学报, 2020, 34(5): 121-126.
[6] 丁玉静,兰兰,王秋菊,冀飞,熊芬,谢林怡,丁海娜,夏寅,赵辉. 外伤导致听力损失的临床特点及预后[J]. 山东大学耳鼻喉眼学报, 2020, 34(1): 9-14.
[7] 叶毅良,卢标清. 704例突发性耳聋疗效分析[J]. 山东大学耳鼻喉眼学报, 2019, 33(5): 44-47.
[8] 卜行宽. WHO全球防聋计划和我国的响应与作用[J]. 山东大学耳鼻喉眼学报, 2019, 33(3): 3-8.
[9] 王亚坤,张宇,宋西成. 不伴有下气道疾病的慢性鼻-鼻窦炎患者肺功能及相关因素分析[J]. 山东大学耳鼻喉眼学报, 2019, 33(1): 99-102.
[10] 刘平,潘晓春,卜川,徐杨斌. 五例患者韦伯偏振试验的局限性报道[J]. 山东大学耳鼻喉眼学报, 2017, 31(3): 115-116.
[11] 杨洪玲. 青光眼患者生活质量评估及相关因素的研究进展[J]. 山东大学耳鼻喉眼学报, 2016, 30(6): 94-97.
[12] 马荣峰,朱富高,孙美红,付涛,张晓恒,曹琳. 突发性聋预后的相关因素分析及疗程选择[J]. 山东大学耳鼻喉眼学报, 2016, 30(4): 69-74.
[13] 狄国华, 刘俊茹, 赵延祥, 高英恺. 利多卡因联合天麻素耳后注射治疗特发性耳鸣[J]. 山东大学耳鼻喉眼学报, 2015, 29(6): 5-7.
[14] 刘绮明,马钊恩,翟锦明,丘理子,毛敏,张建国. 不同类型鼓室图患者中耳共振频率分析[J]. 山东大学耳鼻喉眼学报, 2011, 25(4): 29-31.
[15] 信兆亭1,杨莎莎1,2,吴欣怡1. 干眼影响因素的临床分析[J]. 山东大学耳鼻喉眼学报, 2011, 25(4): 83-86.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
[1] 张晗,黄一飞 . 抗角膜移植排斥的研究进展[J]. 山东大学耳鼻喉眼学报, 2006, 20(1): 84 -87 .
[2] 牛善利,柴茂文,李振秀 . 鼻内镜下鼻甲成形术治疗慢性肥厚性鼻炎60例[J]. 山东大学耳鼻喉眼学报, 2006, 20(1): 16 -18 .
[3] 孟庆国,卢永田,范献良 . 杀伤细胞免疫球蛋白样受体基因多态性与鼻咽癌的关联性[J]. 山东大学耳鼻喉眼学报, 2008, 22(3): 196 -199 .
[4] 马玉起,孔祥春 . 先天性双侧下唇窦道1例[J]. 山东大学耳鼻喉眼学报, 2008, 22(3): 199 -199 .
[5] 万俐佳,鲁海涛,姜义道,刘 辉,李 琴,佘腊枝 . 改良腭咽成形术治疗阻塞性睡眠呼吸暂停综合征41例[J]. 山东大学耳鼻喉眼学报, 2008, 22(3): 204 -205 .
[6] 于青青 ,王跃建 . 硬质耳内镜的临床应用进展[J]. 山东大学耳鼻喉眼学报, 2008, 22(3): 222 -224 .
[7] 吉晓滨,邓家德,臧林泉,王 磊,谢 军 . 豚鼠变应性鼻炎模型血清组胺的测定[J]. 山东大学耳鼻喉眼学报, 2008, 22(3): 228 -230 .
[8] 向登,卢永田,孙焕吉 . 鼻内镜下修补脑脊液鼻漏19例并文献复习[J]. 山东大学耳鼻喉眼学报, 2008, 22(3): 234 -236 .
[9] 邱恩惠,李志春,方文旭 . 嗅觉障碍的中西医治疗[J]. 山东大学耳鼻喉眼学报, 2008, 22(3): 253 -257 .
[10] 殷国华,钟 笑 . 激光减容术治疗舌扁桃体肥大的远期疗效[J]. 山东大学耳鼻喉眼学报, 2008, 22(3): 280 -282 .
网站版权所有 © 2018 《山东大学耳鼻喉眼学报》编辑部　
地址：山东省济南市山大南路27号（250100）电话：+86-0531-88366912 E-mail: ebhxb@sdu.edu.cn
本系统由北京玛格泰克科技发展有限公司设计开发