高频陡降型听损患者助听前后ANL的研究

摘要

Objective The purpose of this study was to compare ANL values under unaided and aided conditions in subjects with steep drop type of hearing loss, as a measure of the effect of hearing aids. Methods Twenty subjects who had used hearing aids for over 6 months for steep drop type of hearing loss were selected. ANL values were measured under unaided and aided conditions, and the differences compared and analyzed using the SPSS19.0 software. Results①Unaided MCL (80.70 ± 8.05 dB HL) and BNL (73.75 ± 7.16 dB HL;) were higher than aided MCL and BNL (65.80 ± 9.03 dB HL and 59.25±6.93 dB HL, respectively) (P<0.001), while unaided and aided ANL values (6.95±4.20 dB HL vs 6.55 ± 4.21 dB HL) were not significantly different (P>0.05);②Real-ear analysis, which evaluates hearing aids ef-fectiveness, and ANL value showed a weak negative correlation (R=-0.2). Conclusions The ANL value may be used to predict effectiveness of hearing aids and guide hearing aid fitting in patients with steep drop type of hearing loss.%目的 探讨可接受噪声级(acceptable noise level,ANL)测试是否适用于评估高频陡降型听力损失人群的助听器选配效果.方法 选取佩戴助听器半年以上的20位高频陡降型的听障患者,对其进行裸耳和助听后的ANL测试、助听情况下的Speechmap测试,通过软件SPSS19.0分析对比助听前后的ANL值和真耳分析的测试结果 ,比较其差异性,评估助听器效果,得出结果.结果 ①20位听障者在裸耳状态时最舒适响度级(most comfortable level,MCL)为80.70±8.05dB HL,助听情况下MCL为65.80±9.03dB HL,具有统计学意义;裸耳状态下背景噪声级(back-ground noise level,BNL)值为73.75±7.16dB HL,助听后BNL值为59.25±6.93dB HL,该结果具有统计学意义(P<0.001),而助听前后ANL值分别为6.95±4.20 dB HL和6.55±4.21 dB HL,该结果无统计学意义(P<0.05),表明患者ANL值与配戴助听器与否无相关性;②助听后Speechmap得分验证了裸耳ANL值小于7dB HL时,助听效果很好;但裸耳ANL值大于7dB HL时患者Speechmap得分偏低,助听效果不好.结论 通过测试裸耳的可接受噪声级(ANL值)可以较为准确地预测高频陡降型听力损失患者选配助听器的效果,并对此类患者是否选配助听器进行指导.