糖尿病患者听力损失的临床特点分析

摘要

Objective To analyze the differences of hearing function between diabetic and healthy patients,and investigate the factors which affect hearing among diabetics.Methods Questionnaires and pure tone audiometry were performed in 1 1 0 patients with type 2 diabetes mellitus who visited Beijing Tongren Hospital,Capital Medical University from October 201 1 to December 201 3,and compared with 40 age- and sex-matched controls.The patients were categorized into groups according to gender,age,duration of diabetes and glycemic control level.Results In all of the 1 1 0 subjects with diabetes,31 cases complained of hearing loss,pure tone audiometry also confirmed the presence of hearing loss;while 79 cases had normal hearing,43 cases (54.4%)of them experienced varying degrees of hearing loss.Hearing threshold in each frequency of diabetic group was significantly higher than the normal group,the difference was statistically significant (P=0.000).And the average hearing levels were significantly lower than those of the control group (P=0.000). The proportion of hearing loss for male (46 /60,76.7%)was significantly higher than that of female (28/50,56%,P=0.021 );the proportion of subjects with hearing loss for all ages,those aged >40 years (60%,60.5%,88.1%)were significantly higher than that of diabetics aged ≤40 years (1 6.7%,25%,P=0.001 ).The prevalence of hearing loss for duration with diabetes ≥1 0 years (45/56, 80.4%)was significantly higher than those <5 years (16/29,55.2%)and 5≤those <10years (13/25,52.0%,P=0.006).The differences of hearing loss in varied glycemic control levels were not statistically significant (P=0.465 ).Conclusion There is a higher risk of damage to auditory function in diabetic patients.The patient's subjective feeling does not reflect their hearing accurately.The occurrence of hearing loss is related with duration of diabetes regardless the level of glycemic control.%目的：分析糖尿病患者与健康者听觉能力差异，探讨糖尿病患者听力损伤的影响因素。方法纳入2011年10月至2013年12月期间，在首都医科大学附属北京同仁医院内分泌科就诊并符合入组条件的2型糖尿病患者110例和无耳科疾病史，年龄与性别相匹配、无高血压、高血糖、高血脂的健康志愿者40例。通过问卷及纯音测听检查调查受试者听力状况。根据性别、年龄、糖尿病病程以及血糖控制水平分组。结果在被调查的110例糖尿病患者中：①31例主诉存在听力损失的患者纯音测听证实均有听力损失；而主诉听力正常的79例患者，有43例（54.4％）出现了不同程度听力损失。②糖尿病组各频率听阈均高于正常对照组，差异有统计学意义（P＝0.000），且平均听力水平较正常对照组差，差异有统计学意义（P＝0.000）。③男性听力损失发病率（46／60，76.7％）高于女性（28／50，56％），差异有统计学意义（P＝0.021）；年龄40岁以上各年龄层的听力损失发病率（60％，60.5％，88.1％）明显高于年龄40岁以下各年龄层的发病率（16.7％，25％），差异有统计学意义（P＝0.001）。④糖尿病病程≥10年者听力损失发病率（45／56，80.4％）高于病程＜5年者（16／29，55.2％）和5年≤病程＜10年者（13／25，52.0％），差异有统计学意义（P＝0.006）。⑤不同血糖控制水平听力损失发病率的差异无统计学意义（P＝0.465）。结论糖尿病患者存在较高的听功能损伤风险。患者的主观感觉不能准确反映其听觉程度，无听力下降主诉的糖尿病患者中约1／2的人群存在听力下降。听力损失的发病率与糖尿病病程有关，与血糖控制水平无关。