老年听力损失患者中耳鸣与听力障碍的关联：一项多中心横断面研究
Association between tinnitus and hearing impairment among older adults with age-related hearing loss: a multi-center cross-sectional study.
作者信息
Chen Zhifeng, Lu Yan, Chen Chenyu, Lin Shaolian, Xie Ting, Luo Xiaoyang, Lin Yanchun, Chen Yuqing, Feng Yong, Xiong Guanxia, Ma Xiulan, Zeng Chaojun, Lin Chang
机构信息
Department of Otorhinolaryngology Head and Neck Surgery, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China.
Department of Otorhinolaryngology Head and Neck Surgery, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, China.
出版信息
Front Neurol. 2024 Dec 17;15:1501561. doi: 10.3389/fneur.2024.1501561. eCollection 2024.
OBJECTIVE
The relationship between tinnitus in the elderly with hearing loss remains elusive. This study aimed to reveal the association between tinnitus and hearing impairment among older adults with age-related hearing loss (ARHL).
METHODS
This cross-sectional study was conducted among a population of outpatients diagnosed with ARHL at four medical centers in different regions of China, from June 2020 to June 2023. ARHL patients were divided into two groups based on their self-reported tinnitus: tinnitus and non-tinnitus. Multivariable linear regression models were used to assess the association between tinnitus and hearing impairment in ARHL patients. Subgroup analyses, stratified by gender and age, were performed to further evaluate the association.
RESULTS
A total of 418 older adults with ARHL were included in the study. Compared to the non-tinnitus group, ARHL patients with tinnitus had lower hearing thresholds ( = -5.07; 95% confidence interval (CI) -9.32 to -0.81; = 0.020). On subgroup analyses stratified by gender and age, the male ARHL patients with tinnitus still had lower hearing thresholds compared to those without tinnitus ( = -6.96; 95% CI -12.70 to 1.22; = 0.018). In females, tinnitus was not associated with hearing thresholds ( = -3.69; 95% CI -10.11 to 2.74, = 0.262). There was no association between tinnitus and hearing thresholds in both the age group of ≥70 years ( = -4.31; 95% CI -9.65 to 1.03; = 0.116) and the age group of <70 years ( = -3.54; 95% CI -9.96 to 2.89; = 0.282).
CONCLUSION
Based on this multi-center cross-sectional study, we reveal that there is no evidence for the assumption that tinnitus may exacerbate hearing loss in the elderly for the first time. On the contrary, tinnitus is associated with better hearing in the male elderly with ARHL. More extensive longitudinal studies are needed to give a comprehensive insight of the present findings and the underlying mechanisms.
目的
老年人耳鸣与听力损失之间的关系仍不明确。本研究旨在揭示年龄相关性听力损失（ARHL）的老年人中耳鸣与听力障碍之间的关联。
方法
本横断面研究于2020年6月至2023年6月在中国不同地区的四个医疗中心对被诊断为ARHL的门诊患者群体进行。ARHL患者根据自我报告的耳鸣情况分为两组：耳鸣组和非耳鸣组。使用多变量线性回归模型评估ARHL患者中耳鸣与听力障碍之间的关联。进行按性别和年龄分层的亚组分析以进一步评估这种关联。
结果
本研究共纳入418例患有ARHL的老年人。与非耳鸣组相比，有耳鸣的ARHL患者听力阈值更低（β = -5.07；95%置信区间（CI）-9.32至-0.81；P = 0.020）。在按性别和年龄分层的亚组分析中，有耳鸣的男性ARHL患者与无耳鸣者相比听力阈值仍更低（β = -6.96；95%CI -12.70至1.22；P = 0.018）。在女性中，耳鸣与听力阈值无关（β = -3.69；95%CI -10.11至2.74，P = 0.262）。在≥70岁年龄组（β = -4.31；95%CI -9.65至1.03；P = 0.116）和<70岁年龄组（β = -3.54；95%CI -9.96至2.89；P = 0.282）中，耳鸣与听力阈值均无关联。
结论
基于这项多中心横断面研究，我们首次揭示没有证据支持耳鸣可能会加重老年人听力损失这一假设。相反，耳鸣与患有ARHL的老年男性较好的听力相关。需要更广泛的纵向研究以全面了解目前的发现及其潜在机制。
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