可接受噪声级测试在助听器效果评估中的初步应用

摘要

目的 探讨可接受噪声级(acceptable noise level,ANL)测试在普通话听障人群助听器效果评估中的应用.方法 选取佩带助听器3个月～3年的中度到中重度听障者37例,根据助听器使用情况将其分为全天使用助听器组、部分时间使用组和拒绝使用组;利用前期经过等价性评估的普通话可接受噪声级测试材料,对三组人群依次进行裸耳和助听下的ANL测试,日常生活助听器满意度问卷(the satisfaction with amplification in daily life,SADL)评估,分析三组ANL值和SADL得分的差异.结果 ①37例听障者个体自身裸耳和助听下最舒适响度级(most comfortable level,MCL)、背景噪声级(background noise level,BNL)值差异有统计学意义(P<0.05),而ANL值差异无统计学意义(P>0.05);②全天使用助听器组裸耳下ANL值明显低于部分时间和拒绝使用助听器组(P<0.05);③全天使用助听器组SADL量表得分高于部分时间使用和拒绝使用助听器组(P<0.05),后两组人群间差异无统计学意义(P>0.05);④Pearson相关分析显示:裸耳ANL值与听障者性别、年龄均无相关性(P>0.05),与气导平均听阈存在较弱相关性(r=0.460,P=0.004).结论 可接受噪声级测试可反映个体耐受噪声能力的大小,可初步利用其来预估助听器选配效果.%Objective The purpose of this study was to compare the difference of ANL value among the full -time hearing aid users, part-time users, and nonusers,and then to determine the relationship between the hearing aid outcomes of the three groups and ANL values. Methods 37 hearing aid users for 3 months to 3 years were selected for this research. Listeners were assigned to one of the three groups based on patterns of hearing aid use:full-time use (whenever hearing aids are needed), part-time use (occasional use), and non use. ANL test was measured for the three groups using the mandarin acceptable noise level test material. The mandarin ANL test was measured in aided and unaided conditions for each group; and the outiones were evaluated by SADL. The results were analyzed statistically with SPSS13.0 to determine the differences of the ANL value for the three groups, and comparison of the SADL scores among the three groups. Results ①There were significant difference of the 37 listeners' MCL and BNL value in the unaided and aided conditions (P＜0.05), but the difference of the listeners ANLs value was not found with and without hearing aids. ②The mean ANLs of the three groups were: 8 (full-time use),12 (part-time use), 16 (nonuse) dB HL, there was significant difference among the three groups (P＜0. 05). ③ The SADL score of the three groups were 67.9 (full- time use), 58.0 (part-time use), 55.2 (nonuse). There were significant difference (P＜0. 05) among the three groups, but no difference was found between the part-time users and nonuser. ④The ANLs was unrelated to the listener' gender and age, but the ANLs correlated with the HTL ( average of HLs at 0. 5, 1, 2, 4 kHz). Conclusion The ANL value are unaffected by amplification. The ANL value for the full-time hearing aid users are significantly lower than the part-time users and nonusers, and the SADL score are better than the other groups, suggesting that the ANL is inherent to an individually and can be established prior to hearing aid fitting as a possible predictor of hearing-aid use.