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慢性阻塞性肺疾病患者听觉功能的研究

Study of auditory function in patients with chronic obstructive pulmonary diseases.

作者信息

el-Kady Mona A, Durrant John D, Tawfik Somia, Abdel-Ghany Sarhan, Moussa Abdel-Mateen

机构信息

Department of Communication Science and Disorders, University of Pittsburgh, United States.

出版信息

Hear Res. 2006 Feb;212(1-2):109-16. doi: 10.1016/j.heares.2005.05.018. Epub 2006 Jan 18.

Abstract

This study was designed to measure auditory function in patients with chronic obstructive pulmonary diseases (COPDs) who generally suffer from chronic hypoxemia. Control and COPD subject groups received a battery of tests to assess overall hearing sensitivity and peripheral (end-organ and eighth-nerve) and brain-stem auditory function, as well as blood-gas analysis. Results showed a statistically significant difference for all audiological measures between the control group and a COPD subgroup--the presumptive hypoxic subjects (partial oxygen tensions, PO2, <75 mm Hg). Correlation analyses of results from all subjects (regardless of PO2) also revealed significant covariance with PO2 for overall, RMS, amplitude of click-evoked otoacoustic emissions (RA), hearing threshold level, and auditory brain-stem response (ABR, I-V inter-peak latency). Chi2 or Fisher's exact tests were statistically significant for frequencies of cases classified according to a criterion PO2 of 70 mm Hg (putative critical O2 for completely normal auditory function) and either hearing thresholds falling below or RA values above 1.5 standard deviations of the control-group means, respectively. However, chi2 was not significant for a comparable criterion of ABR I-V IPL. In general, clinically significant hearing loss was uncommon in COPD patients, and the observed effects represented relatively small changes in the auditory measures examined. Still, overall, changes were in the direction of poorer function, and these results suggest physiologically significant impact of chronic hypoxemia and the need for further study to evaluate thoroughly this medical condition as a potential risk factor for audio-vestibular dysfunction.

摘要

本研究旨在测量慢性阻塞性肺疾病(COPD)患者的听觉功能,这类患者通常患有慢性低氧血症。对照组和COPD受试者组接受了一系列测试,以评估整体听力敏感度、外周(终末器官和第八对脑神经)及脑干听觉功能,以及血气分析。结果显示,对照组与一个COPD亚组——推测为低氧的受试者(部分氧分压,PO2,<75 mmHg)之间,所有听力学测量指标均存在统计学上的显著差异。对所有受试者(无论PO2水平如何)的结果进行相关性分析,还发现整体、均方根、短声诱发耳声发射(RA)幅度、听力阈值水平及听觉脑干反应(ABR,I-V峰间潜伏期)与PO2之间存在显著协方差。对于根据70 mmHg的PO2标准(假定为完全正常听觉功能的临界氧分压)分类的病例频率,以及听力阈值低于或RA值高于对照组均值1.5个标准差的情况,卡方检验或费舍尔精确检验具有统计学显著性。然而,对于ABR I-V峰间潜伏期的类似标准,卡方检验并不显著。总体而言,临床上显著的听力损失在COPD患者中并不常见,观察到的影响在所检查的听觉测量指标中表现为相对较小的变化。尽管如此,总体上变化趋势是功能变差,这些结果表明慢性低氧血症具有生理上的显著影响,并且需要进一步研究以全面评估这种疾病作为音频-前庭功能障碍潜在危险因素的情况。

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