Lee Fu-Shing, Matthews Lois J, Dubno Judy R, Mills John H
Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina 29425, USA.
Ear Hear. 2005 Feb;26(1):1-11. doi: 10.1097/00003446-200502000-00001.
OBJECTIVE: Pure-tone thresholds for conventional and extended high frequencies were analyzed for 188 older adult human subjects (91 females, 97 males). The objectives were to study longitudinal changes in thresholds as well as the effects of initial threshold levels, age, gender, and noise history on these longitudinal changes. DESIGN: At the time of entry into the study, subjects' ages ranged from 60 to 81 years, with a mean age of 68 years. Subjects had between 2 and 21 visits (mean = 9.81 visits) over a period of 3 to 11.5 years (mean = 6.40 years). Conventional pure-tone thresholds at 0.25 to 8 kHz were measured during most visits. Extended high-frequency (EHF) thresholds at 9 to 18 kHz were measured every 2 to 3 years. The slope of a linear regression was used to estimate the rate of change in pure-tone thresholds at 0.25 to 18 kHz for each ear. A questionnaire was used to identify those subjects with a positive noise history. RESULTS: The average rate of change in thresholds was 0.7 dB per year at 0.25 kHz, increasing gradually to 1.2 dB per year at 8 kHz and 1.23 dB per year at 12 kHz. The rate of change for thresholds increased significantly with age, at 0.25 to 3, 10, and 11 kHz for females and at 6 kHz for males. After adjusting for age, females had a significantly slower rate of change at 1 kHz but a significantly faster rate of change at 6 to 12 kHz than males. For 0.25 and 1 kHz, subjects with more hearing loss at higher frequencies had a faster rate of change at these frequencies, whereas for 6 and 8 kHz, subjects with more hearing loss at mid and high frequencies had a slower rate of change at these frequencies. The rates of threshold change for subjects with a positive noise history were not statistically different from those with a negative noise history. CONCLUSIONS: On average, hearing threshold increased approximately 1 dB per year for subjects age 60 and over. Age, gender, and initial threshold levels can affect the rate of change in thresholds. Older female subjects (> or =70 years) had faster rate of change at 0.25 to 3, 10, and 11 kHz than younger female subjects (60 to 69 years). Older male subjects had faster rate of change at 6 kHz than younger male subjects. Females had a slower rate of change at 1 kHz and a faster rate of change at 6 to 12 kHz than males. Subjects with higher initial thresholds at low and mid frequencies tended to have faster rate of threshold change at 0.25 to 2 kHz in the following years. Subjects with higher initial thresholds at mid and higher frequencies tended to have slower rate of change at 6 to 8 kHz in the following years. Noise history did not have a significant effect on the rate of threshold changes.
目的：对188名老年受试者（91名女性，97名男性）的传统和扩展高频纯音听阈进行分析。目的是研究听阈的纵向变化以及初始听阈水平、年龄、性别和噪声暴露史对这些纵向变化的影响。 设计：在进入研究时，受试者年龄在60至81岁之间，平均年龄为68岁。受试者在3至11.5年（平均 = 6.40年）的时间内进行了2至21次就诊（平均 = 9.81次）。在大多数就诊期间测量0.25至8kHz的传统纯音听阈。每2至3年测量一次9至18kHz的扩展高频（EHF）听阈。使用线性回归斜率估计每只耳朵在0.25至18kHz的纯音听阈变化率。使用问卷确定那些有阳性噪声暴露史的受试者。 结果：在0.25kHz时，听阈的平均变化率为每年0.7dB，逐渐增加到8kHz时每年1.2dB和12kHz时每年1.23dB。听阈变化率随年龄显著增加，女性在0.25至3、10和11kHz，男性在6kHz时变化率增加。在调整年龄后，女性在1kHz时的变化率明显较慢，但在6至12kHz时的变化率明显快于男性。对于0.25和1kHz，高频听力损失较多的受试者在这些频率的变化率较快，而对于6和8kHz，中高频听力损失较多的受试者在这些频率的变化率较慢。有阳性噪声暴露史的受试者的听阈变化率与有阴性噪声暴露史的受试者在统计学上没有差异。 结论：平均而言，60岁及以上受试者的听力阈值每年增加约1dB。年龄、性别和初始听阈水平会影响听阈变化率。老年女性受试者（≥70岁）在0.25至3、10和11kHz的变化率比年轻女性受试者（60至69岁）快。老年男性受试者在6kHz的变化率比年轻男性受试者快。女性在1kHz的变化率较慢，在6至12kHz的变化率比男性快。低频和中频初始听阈较高的受试者在接下来的几年中在0.25至2kHz的听阈变化率往往较快。中高频初始听阈较高的受试者在接下来的几年中在6至8kHz的变化率往往较慢。噪声暴露史对听阈变化率没有显著影响。
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