首都医科大学学报 ›› 2019, Vol. 40 ›› Issue (1): 35-39.doi: 10.3969/j.issn.1006-7795.2019.01.007

• 糖尿病慢性合并症-听力损失与平衡障碍研究 • 上一篇    下一篇

畸变产物耳声发射在社区糖尿病患者听力监测中的应用

辛玲玉1, 李谨1, 高迎2, 马肖钰1, 刘博1   

  1. 1. 首都医科大学附属北京同仁医院耳鼻咽喉头颈外科 北京市耳鼻咽喉科研究所 耳鼻咽喉科学教育部重点实验室, 北京 100005;
    2. 北京市东城区第一人民医院内分泌科, 北京 100075
  • 收稿日期:2018-12-06 出版日期:2019-01-21 发布日期:2019-01-23
  • 通讯作者: 刘博 E-mail:trliubo@139.com
  • 基金资助:
    首都卫生发展科研专项(首发重点2018-1-1091)。

Application of distortion product otoacoustic emission in hearing screening of diabetes mellitus patients

Xin Lingyu1, Li Jin1, Gao Ying2, Ma Xiaoyu1, Liu Bo1   

  1. 1. Department of Otorhinolaryngology, Beijing Tongren Hospital, Capital Medical University;Beijing Institute of Otorhinolaryngology;Key Laboratory of Otorhinolaryngology Head and Neck Surgery, Ministry of Education, Beijing 100005, China;
    2. Department of Endocrinology, The First People's Hospital of Dongcheng, Beijing 100075, China
  • Received:2018-12-06 Online:2019-01-21 Published:2019-01-23
  • Supported by:
    This study was supported by Capital Health Research and Development of Special(2018-1-1091).

摘要: 目的 了解社区2型糖尿病(type 2 diabetes mellitus,T2DM)患者听力损失知晓率及听力现状,探讨畸变产物耳声发射(distortion products otoacoustic emission,DPOAE)在社区T2DM患者听功能监测中的应用。方法 2018年4月至2018年10月,因糖尿病就诊于北京市东城区天坛社区卫生服务中心和北京市东城区永外社区卫生服务中心T2DM患者156例,其中,男性69例,女性87例,年龄20~79岁,平均年龄(62.74 ±6.54)岁。对所有患者进行问卷调查、纯音听力检查、声导抗检查和DPOAE检查。结果 听力下降组的DPOAE幅值在各频率较听力正常组降低,其中在1.5 kHz差异有统计学意义(P=0.014)。312耳中,主诉听力下降98耳(31.41%),DPOAE检查1.5 kHz下降242耳(77.56%)(P=0.000);老年组230耳,主诉听力下降67耳(29.13%),DPOAE检查1.5 kHz下降190耳(82.61%)(P=0.000);中青年组82耳,主诉听力下降31耳(37.80%),DPOAE检查1.5 kHz下降52耳(63.41%)(P=0.001)。312耳经纯音听力检查发现听力下降216耳(69.23%)。其中主诉听力正常214耳中,纯音听力检查发现130耳(60.75%)存在不同程度的听力下降(P=0.000)。老年组纯音听力检查耳听力下降165耳(71.74%)(P=0.000);中青年组纯音听力检查证实51耳(62.20%)听力下降(P=0.002)。结论 社区糖尿病患者听力损失发生率高,但知晓率较低,DPOAE检查可在主诉听力下降之前发现耳蜗外毛细胞功能状态的改变,社区糖尿病患者应尽早进行听力保健的健康教育并择时进行听力检查。

关键词: 糖尿病, 畸变产物耳声发射, 听力下降

Abstract: Objective To figure out the hearing loss awareness rate and hearing situation of type 2 diabetes mellitus (T2DM) patients of the community, and further to investigate application of distortion products otoacoustic emission (DPOAE) in community T2DM patients. Methods From April 2018 to October 2018, 156 T2DM patients aged 20-79 years in the community were enrolled, including 69 males and 87 females, with average age (62.74 ±6.54)years old. All the patients were investigated by questionnaire, pure tone audiometer (PTA), acoustic conduction resistance test, and DPOAE test. Results DPOAE amplitudes of each frequency was lower than the normal amplitudes, amplitudes of the hearing loss group was lower in each frequency than that of no hearing loss group, the difference in 1.5 kHz was statistically significant (P=0.014). Among 312 ears, 98 ears (31.41%) self-report of hearing loss, 242 ears (77.56%) hearing loss at 1.5 kHz on DPOAE examination, (P=0.000). In aged group, 67 ears (29.13%) with self-report of hearing loss and 190 ears (82.61%) hearing loss at 1.5kHz with DPOAE examination(P=0.000). In middle-aged group, 82 ears (37.80%) self-report of hearing loss of patients, and 52 ears (63.41%) at DPOAE 1.5 kHz was hearing loss (P=0.001). In all ears, 216 ears (69.23%) of hearing loss with PTA. Among 214 ears self-report of normal hearing, PTA found that 130 ears (60.75%) was hearing loss (P=0.000). In aged group, 165 ears of hearing loss (71.74%)with PTA(P=0.000). In middle-aged group, PTA suggest 51 ears (62.20%) of hearing loss (P=0.002). Conclusion The detection rate with DPOAE for hearing loss in T2DM patients was higher than that with pure tone audiometer. When middle-aged patients have no conscious of hearing loss, their DPOAE examination has identified the abnormalities. Middle-aged diabetic patients in the community should receive health education of hearing care and hearing screening as early as possible.

Key words: diabetes mellitus, distortion products otoacoustic emission, hearing loss

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