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[职业性噪声性聋患者双耳不对称性听力损失分析]

[Analysis of asymmetric hearing loss in both ears of patients with occupational noise-induced deafness].

作者信息

Xiao W L, Yang A C, Li X L, Zhou S Y, Li B, Liang X Y

机构信息

Foshan City Sanshui Disease Prevention and Cure Station, Foshan 528100, China.

Guangdong Province Hospital for Occupational Disease Prevention and Treatment, Guangdong Provincial Key Laboratory of Occupational Disease Prevention and Treatment, Guangzhou 510300, China.

出版信息

Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi. 2020 May 20;38(5):345-349. doi: 10.3760/cma.j.cn121094-20190814-00339.

Abstract

To investigate the characteristics of asymmetric hearing loss in left and right ears of patients with occupational noise-induced deafness and to explore the possible causes of asymmetric hearing loss. A total of 423 cases of occupational noise-induced deafness diagnosed in Guangdong Province Hospital for Occupational Disease Prevention and Treatment from May 2015 to May 2018 were investigated retrospectively. On the basis of three consecutive pure tone audiometry (PTA) with intervals of more than 3 d in hospital, the minimum of hearing threshold of each frequency and the frequency response threshold of auditory steady-state response (ASSR) , and based on the GBZ 49-2014 "Diagnosis of Occupational Noise-induced Deafness". The statistical analysis of Wilcoxon signed rank test and Spearman correlation analysis were carried out by nonparametric test. The hearing threshold weight of PTA and the response threshold of ASSR were tested and compared from different dimensions according to sex, age, length of service of exposure noise, diagnosis grade and so on. There were 369 male (87.23%) and 54 female (12.77%) ; the age was (41.8±7.6) years; the length of service was (10.1±6.2) years. The weighted values of left ear PTA and ASSR were higher than those of right ear (<0.001) . The weighted values of left ear PTA and ASSR were higher than those of right ear (<0.05) in men, patients with age ≤ 40 and 41-60 years, 3-9 years of service, and patients with mild grade (<0.05) . After the equalization of characteristic variables, the weighted values of left ear PTA and ASSR were also higher than those of right ear (<0.05) . There was a positive correlation between the weighted value of PTA and the weighted value of ASSR (<0.001) . There is asymmetry in hearing loss of patients with occupational noise deafness, and hearing loss in the left ear is higher than that in the right ear.

摘要

探讨职业性噪声性聋患者双耳不对称性听力损失的特点,探索不对称性听力损失的可能原因。回顾性调查2015年5月至2018年5月在广东省职业病防治院确诊的423例职业性噪声性聋患者。在医院间隔3天以上连续3次纯音听力测试(PTA)的基础上,测定各频率听力阈值最小值及听性稳态反应(ASSR)频率反应阈值,并依据GBZ 49-2014《职业性噪声聋诊断》标准。采用非参数检验进行Wilcoxon符号秩检验和Spearman相关分析。根据性别、年龄、接触噪声工龄、诊断分级等不同维度对PTA听力阈值加权值和ASSR反应阈值进行测试比较。其中男性369例(87.23%),女性54例(12.77%);年龄(41.8±7.6)岁;工龄(10.1±6.2)年。左耳PTA和ASSR加权值均高于右耳(<0.001)。男性、年龄≤40岁及41 - 60岁、工龄3 - 9年、轻度分级患者中左耳PTA和ASSR加权值高于右耳(<0.05)。特征变量均衡后,左耳PTA和ASSR加权值仍高于右耳(<0.05)。PTA加权值与ASSR加权值呈正相关(<0.001)。职业性噪声聋患者存在听力损失不对称性,左耳听力损失高于右耳。

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