Geng W, Zhang L R, Li W, Chen L Y, Ma X B, Liu Z H
Department of Radiology, Fuxing Hospital, Capital Medical University, Beijing 100038, China.
Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China.
Zhonghua Yu Fang Yi Xue Za Zhi. 2022 Jul 6;56(7):980-984. doi: 10.3760/cma.j.cn112150-20220413-00358.
To provide basis for prevention and treatment by analyzing the clinical features, emotional and cognitive states and their correlations of idiopathic tinnitus. Cross-sectional study was used. Thirty-six right, 44 left, and 46 bilateral idiopathic tinnitus patients diagnosed in Beijing Tongren Hospital were prospectively enrolled from October, 2020 to February, 2022. The clinical data was recorded and the THI, DBI, STAI, and MoCA were evaluated. The clinical features and the incidence of severe tinnitus, hearing lose, anxiety, and cognitive impairment were compared by one-way ANOVA, Kruskal-Wallis , and chi-square test. The correlation between tinnitus or hearing and emotional and cognitive states were evaluated by multivariable correlation analysis. There was no significant difference in age, BMI, years of education, tinnitus duration, and the incidence of hearing loss among groups (=0.730,=0.484;=1.535,=0.219;=1.506,=0.226;χ²=4.242,=0.120;χ²=6.672,=0.083). In right, left, and bilateral tinnitus patients, the number of severe tinnitus was 12, 7, and 20 cases and the incidence was 33.3%, 15.9%, and 43.5%; the number of depression was 13, 14, and 26 cases and incidence was 36.1%, 31.8%, and 53.5%; the number of trait anxiety was 3, 2, and 10 cases and the incidence was 8.3%, 4.5%, and 21.7%. Compared with left tinnitus patients, the incidence of severe tinnitus, depression, and trait anxiety was higher in bilateral tinnitus patients (χ²=8.139,=0.004;χ²=5.558,=0.018;χ²=5.753,=0.007). The incidence of state anxiety and cognitive impairment were no significant difference among groups (χ²=0.142,=0.931;χ²=1.338,=0.512). The overall incidence of state anxiety and cognitive impairment were 16.7%(21/126) and 37.3%(47/126) respectively. There was positive correlation between THI score and BDI, S-AI, and T-AI scores (=0.529,=0.001; =0.649,<0.001; =0.483,=0.003) and negative correlation between THI and MoCA scores (=-0.364,=0.029) in right tinnitus group. The positive correlation was found between THI score and BDI, S-AI, and T-AI scores in left tinnitus group (=0.508,<0.001; =0.506,<0.001; =0.357,=0.017). The positive correlation between THI score and BDI, S-AI, and T-AI scores (=0.753,<0.001; =0.527,<0.001; =0.536,<0.001) and the positive correlation between tinnitus duration and MoCA score(=0.334,=0.023) were also found in bilateral tinnitus group.
通过分析特发性耳鸣的临床特征、情绪和认知状态及其相关性，为防治提供依据。采用横断面研究。2020年10月至2022年2月前瞻性纳入在北京同仁医院诊断的36例右侧、44例左侧和46例双侧特发性耳鸣患者。记录临床资料并评估耳鸣残疾指数（THI）、抑郁自评量表（DBI）、状态-特质焦虑问卷（STAI）和蒙特利尔认知评估量表（MoCA）。采用单因素方差分析、Kruskal-Wallis检验和卡方检验比较临床特征以及重度耳鸣、听力损失、焦虑和认知障碍的发生率。通过多变量相关性分析评估耳鸣或听力与情绪和认知状态之间的相关性。各组间年龄、体重指数、受教育年限、耳鸣持续时间和听力损失发生率无显著差异（F = 0.730，P = 0.484；F = 1.535，P = 0.219；F = 1.506，P = 0.226；χ² = 4.242，P = 0.120；χ² = 6.672，P = 0.083）。右侧、左侧和双侧耳鸣患者中，重度耳鸣例数分别为12、7和20例，发生率分别为33.3%、15.9%和43.5%；抑郁例数分别为13、14和26例，发生率分别为36.1%、31.8%和53.5%；特质焦虑例数分别为3、2和10例，发生率分别为8.3%、4.5%和21.7%。与左侧耳鸣患者相比，双侧耳鸣患者重度耳鸣、抑郁和特质焦虑的发生率更高（χ² = 8.139，P = 0.004；χ² = 5.558，P = 0.018；χ² = 5.753，P = 0.007）。各组间状态焦虑和认知障碍的发生率无显著差异（χ² = 0.142，P = 0.931；χ² = 1.338，P = 0.512）。状态焦虑和认知障碍的总发生率分别为16.7%（21/126）和37.3%（47/126）。右侧耳鸣组中，THI评分与BDI、S-AI和T-AI评分呈正相关（r = 0.529，P = 0.001；r = 0.649，P < 0.001；r = 0.483，P = 0.003），THI与MoCA评分呈负相关（r = -0.364，P = 0.029）。左侧耳鸣组中，THI评分与BDI、S-AI和T-AI评分呈正相关（r = 0.508，P < 0.001；r = 0.506，P < 0.001；r = 0.357，P = 0.017）。双侧耳鸣组中，THI评分与BDI、S-AI和T-AI评分也呈正相关（r = 0.753，P < 0.001；r = 0.527，P < 0.001；r = 0.536，P < 0.001），耳鸣持续时间与MoCA评分呈正相关（r = 0.334，P = 0.023）。
