225例听神经病患者的耳鸣发生特点及临床特征分析

摘要

目的调查听神经病患者的耳鸣发生情况,并分析伴发耳鸣的听神经病患者的临床特征及听力学特点.方法对225例听神经病患者(均可准确陈述病史)进行病史采集及纯音测听、声导抗、听性脑干反应、DPOAE、言语识别率、耳蜗电图等听力学检测,并对结果总结分析.结果①225例听神经病患者就诊年龄3~45岁,男女比例1：1.23,发生耳鸣的患者126例,比例达56%,青少年期及青年期发病的患者耳鸣发生率最高,分别为63.03%(75/119)和66.67%(32/48)；②男性和女性患者耳鸣发生率分别为52.48%和58.87%,差异无统计学意义；③耳鸣发生率随病程增长而增高,病程10年以上的听神经病患者耳鸣发生率高达82.14%(23/28)；④综合征型听神经病患者耳鸣发生率明显高于非综合征性听神经病患者(84.00%>42.00%)；⑤轻中度听力损失的听神经病患者耳鸣发生率明显高于其他听力损失类型.结论本组听神经病患者耳鸣发生与听神经病发病年龄、病程、听力损失程度及类型有一定相关性.听神经病患者耳鸣发生的临床特征分析对进一步探讨听神经病患者耳鸣发生机理提供临床资料.%Objective To investigate the occurrence of tinnitus in patients with auditory neuropathy and analyze their clinical and audiological characteristics. Methods Clinical history, physical examination and audiological examination data (including pure tone audiometry, acoustic impedance, ABRs, DPOAEs, speech perception and ECochG) were reviewed and analyzed in 225 patients with auditory neuropathy (age 3 to 45 years, male to female ratio=1:1.23 ). Results 1) Tinnitus was reported by 126 of the 225 AN patients (56%), more in adolescent patients. 2) Incidence of tinnitus in male and female patients was 52.48% and 58.87%, respectively, without significant difference (P>0.05). 3) The incidence of tinnitus in⁃creased as the duration of AN,increased and was as high as 82.14%in patients with an AN history longer than 10 years. 4) The incidence of tinnitus in syndromic AN patients was significantly higher than in non-syndromic AN patients (84.00%vs 42.00%). 5) AN patients with mild to moderate hearing loss were more likely to have tinnitus than AN patients with other levels of hearing loss. Conclusion The occurrence of tinnitus in AN patients is correlated with age of disease onset, duration of disease, degree of hearing loss and pattern of hearing loss. Analysis of clinical characteristics of tinnitus in AN patients may facilitate further research in pathogenesis of tinnitus in AN patients.