焦虑抑郁状态与特发性耳鸣预后的相关性研究

doi:10.6040/j.issn.1673-3770.0.2022.551

摘要/Abstract

摘要： 目的探讨特发性耳鸣患者的焦虑抑郁状态,同时研究可能影响耳鸣预后的因素。方法回顾性分析100例特发性耳鸣患者的临床资料,采用统一的耳鸣治疗方案,治疗12周后进行随访来评价疗效并分析可能影响耳鸣预后的因素。结果各量表治疗后效应良好,且差异均有统计学意义(P<0.05)。中重度组耳鸣患者广泛性焦虑障碍量表得分(Z=-6.482, P<0.001)、抑郁筛查量表得分(Z=-6.070, P<0.001)较轻度组更高。性别(P=0.216)、年龄(P=0.972)、耳鸣侧别(P=0.703)、响度(P=0.264)、频率(P=0.446)、病程(P=0.728)及听力损失程度(P=0.234),各组之间与耳鸣预后无明显相关性;治疗前耳鸣残疾评估量表(tinnitus handicap inventory, THI)得分(OR=1.028,P=0.003)、治疗后焦虑改善(OR=5.637, P<0.001)、抑郁改善(OR=4.200, P=0.001)、睡眠改善(OR=4.744, P=0.008)及耳鸣临床治愈(OR=7.306, P<0.001),各组之间耳鸣的预后差异均有统计学意义。多元线性回归分析示,治疗前THI得分、耳鸣临床治愈及治疗后焦虑改善均是耳鸣预后的相关因素(P均<0.05)。结论耳鸣的预后与性别、年龄、耳鸣侧别、响度、频率、病程及听力损失程度无关,与治疗前THI得分有关,且治疗后焦虑改善、抑郁改善、睡眠改善及耳鸣临床治愈是耳鸣预后良好的正性因素。中重度组耳鸣患者的焦虑抑郁状态较轻度组更重,故临床上应重视中重度耳鸣患者的精神心理状态。

关键词: 特发性耳鸣, 焦虑, 抑郁, 睡眠障碍, 量表, 预后

Abstract: Objective To study the anxiety and depression status of patients with idiopathic tinnitus and analyze the factors that may affect the prognosis of tinnitus. Methods The clinical data of 100 patients with idiopathic tinnitus were retrospectively analyzed. A uniform tinnitus treatment protocol was used. Patients were followed -up after 12 weeks of treatment to evaluate the efficacy and analyze the factors that may affect the prognosis of tinnitus. Results The effect of each scale after treatment was more than 0.50, and the difference was statistically significant(P<0.05). The GAD-7 score(Z=-6.482, P<0.001)and PHQ-9 score(Z=-6.070, P<0.001)were higher in the moderate-severe than in the mild tinnitus group. There were no statistically significant differences in the prognosis of tinnitus between the groups in terms of sex, age, side of tinnitus, loudness of tinnitus, frequency of tinnitus, degree of hearing loss, and duration of tinnitus disease(P>0.05). The pre-treatment THI score(OR=1.028, P=0.003), post-treatment improvement in anxiety(OR=5.637, P<0.001), post-treatment improvement in depression(OR=4.200, P=0.001), sleep improvement after treatment(OR=4.744, P=0.008)and clinical cure of tinnitus(OR=7.306, P<0.001)were independently associated with tinnitus prognosis. The multiple linear regression analysis results suggested that the pre-treatment THI score, clinical cure of tinnitus, and anxiety improvement after treatment positively correlated with tinnitus prognosis(all P<0.05). Conclusion Gender, age, side of tinnitus, loudness of tinnitus, frequency of tinnitus, degree of hearing loss, and tinnitus duration were not significantly associated with the prognosis. Conversely, the pre-treatment THI score, anxiety improvement after treatment, depression improvement after treatment, sleep improvement after treatment, and clinical cure of tinnitus were independently associated with tinnitus prognosis. The overall severity of tinnitus was positively associated with the anxiety-depression status. The anxiety-depression status of patients in the moderate-severe tinnitus group was more severe than that in the mild tinnitus group. Hence, clinical attention should be paid to the psychosocial status of patients with moderate-severe tinnitus.

Key words: Idiopathic Tinnitus, Anxiety, Depression, Somnipathy, Scale, Prognosis

中图分类号:

765.21

吴波,黄天德,闫斌,陈伊,汤勇. 焦虑抑郁状态与特发性耳鸣预后的相关性研究[J]. 山东大学耳鼻喉眼学报, 2023, 37(4): 46-52.

WU Bo, HUANG Tiande, YAN Bin, CHEN Yi, TANG Yong. Correlation between the anxiety-depression state and idiopathic tinnitus prognosis[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2023, 37(4): 46-52.

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