老年性聋患者助听器停用情况及与听觉和社会因素的相关性

王昌阳; 慈军; 管骅

doi:10.16766/j.cnki.issn.1674-4152.002806

老年性聋患者助听器停用情况及与听觉和社会因素的相关性

doi: 10.16766/j.cnki.issn.1674-4152.002806

浙江省中西医结合医院耳鼻咽喉科, 浙江杭州 310000

基金项目:

浙江省医药卫生科技计划项目 2020KY740

详细信息

通讯作者:
王昌阳，E-mail：lwc791110@126.com

中图分类号: R764.436R764.5
计量
- 文章访问数: 118
- HTML全文浏览量: 24
- PDF下载量: 5
- 被引次数: 0
出版历程
- 收稿日期: 2022-02-11
- 网络出版日期: 2023-04-07

Relationship between hearing aid discontinuance and auditory and social factors in patients with senile deafness

Department of Otorhinolaryngology, Zhejiang Integrated Traditional Chinese and Western Medicine Hospital, Hangzhou, Zhejiang 310000, China

摘要

摘要: 目的比较老年性聋患者助听器停用和正常应用情况，分析其与听觉和社会等因素的相关性，以提高助听器使用率。方法将2018年1月—2020年1月于浙江省中西医结合医院耳鼻喉科验配助听器的老年性聋患者186例纳入分析，根据患者1年后助听器停用情况分为停用组和正常组。比较2组患者听力情况、社会因素等临床资料，采用多因素logistic回归分析研究影响老年性聋患者助听器停用的相关因素。结果纳入研究的患者中有69例出现了助听器停用(停用组)，剩余117例正常应用助听器(正常组)，助听器停用率为37.10%。停用组助听器价格＜1.5万元助听器所占比例、老年听力障碍量表筛查版(HHIE-S)评分和纯音听阈均值大于正常组(均P＜0.05)；停用组言语识别率、日常社交次数、离退休所占比例和每年外出旅游次数小于正常组(均P＜0.05)。多因素logistic回归分析显示：HHIE-S评分升高(OR=1.625)、助听器价格＜1.5万元(OR=3.112)和纯音听阈均值升高(OR=1.166)是影响老年性聋患者助听器停用的独立危险因素；言语识别率升高(OR=0.820)和日常社交次数增多(OR=0.277)是影响老年性聋患者助听器停用的保护性因素。由等高线图可见，随着日常社交次数增加和语言识别率升高，助听器停用风险逐渐降低。结论日常社交次数和语言识别率是影响老年性聋患者助听器停用的最重要因素，早期监测有助于及时调整治疗方案，提高助听器应用率。
- 老年性聋 /
- 助听器 /
- 听觉情况 /
- 社会因素
Abstract: Objective This study aimed to improve the utilisation rate of hearing aids, the disuse and normal use of hearing aids in patients with senile deafness were compared to analyse its correlation with auditory and social factors. Methods From January 2018 to January 2020, 186 cases of patients with senile deafness equipped with hearing aids in the Department of Otolaryngology of Zhejiang Hospital of Integrated Traditional Chinese and Western Medicine were analysed. According to the discontinuation of hearing aids after 1 year, the patients were divided into discontinuation group and normal group. The clinical data of hearing and social factors were compared between the two groups. Multivariate Logistic regression was used to analyse the related factors of hearing aid discontinuance in patients with senile deafness. Results Amongst the patients included in the study, 69 with hearing aid discontinuance were classified as the discontinuance group, and the remaining 117 patients with continuous normal use of hearing aids were classified as the normal group. In addition, the hearing aid discontinuation rate was 37.10%. The proportion of hearing aids costing < 15 000 yuan, the Hearing Impairment in Elderly Inventory Screening version (HHIE-S) score and the mean of pure tone hearing threshold in the discontinuance group were higher than those in the normal group (all P < 0.05). The speech recognition rate, times of daily socialisation, proportion of retirees and times of annual traveling in the discontinuance group were lower than those in the normal group (all P < 0.05). Multivariate logistic linear regression analysis showed that the increase of HHIE-S score (OR=1.625), the increase of hearing aids price < 15 000 yuan (OR=3.112) and the increase of pure tone threshold (OR=1.166) were independent risk factors influencing hearing aid withdrawal in patients with senile deafness. Increased speech recognition rate (OR=0.820) and increased daily social interaction (OR=0.277) were the protective factors influencing hearing aid withdrawal in patients with senile deafness. As seen in the contour plot, with the number of daily social interactions increases and the language recognition rate increases, the risk of hearing aid deactivation gradually decreases. Conclusion Daily social contact frequency and language recognition rate are the most important factors affecting hearing aid withdrawal in patients with senile deafness. Early monitoring helps to adjust the treatment plan in time and improve the application rate of hearing aid.
- Senile deafness /
- Hearing aids /
- Auditory condition /
- Social factors

HTML全文

图 1 基于听觉和社会因素预测老年性聋患者助听器停用风险的等高线模型

Figure 1. Contour model for predicting the risk of hearing aid discontinuation in patients with senile deafness based on auditory and social factors

下载: 全尺寸图片幻灯片

表 1 2组老年性聋患者一般资料比较

Table 1. Comparison of general data between the two groups

项目	停用组(n=69)	正常组(n=117)	统计量	P值
年龄(x±s，岁)	72.06±9.45	71.53±10.02	0.356^a	0.722
性别[例(%)]			0.041^b	0.949
男性	38(55.07)	65(55.56)
女性	31(44.93)	52(44.44)
病程(x±s，年)	3.68±1.17	3.42±0.89	1.708^a	0.089
合并疾病[例(%)]			0.521^b	0.471
2种及以下	26(37.68)	38(32.48)
3种及以上	43(62.32)	79(67.52)
助听器价格[例(%)]			7.681^b	0.006
＜1.5万元	44(63.77)	50(42.74)
≥1.5万元	25(36.23)	67(57.26)
助听器情况[例(%)]			0.355^b	0.552
单耳	42(60.87)	66(56.41)
双耳	27(39.13)	51(43.59)
助听器样式[例(%)]			0.165^b	0.685
耳背式	52(75.36)	85(72.65)
耳道式	17(24.64)	32(27.35)
注：^a为t值，^b为χ²值。

下载: 导出CSV

表 2 2组老年性聋患者听力情况比较

Table 2. Comparison of hearing status between the two groups

组别	例数	HHIE-S评分(x±s，分)	伴耳鸣[例(%)]	纯音听阈均值(x±s，dB)	言语识别率(x±s，%)
停用组	69	19.26±2.23	42(60.86)	69.06±10.41	70.94±8.96
正常组	117	17.54±1.92	57(48.72)	60.13±9.15	84.78±9.59
统计量		5.555^a	2.574^b	6.106^a	9.739^a
P值		＜0.001	0.109	＜0.001	＜0.001
注：^a为t值，^b为χ²值。

下载: 导出CSV

表 3 2组老年性聋患者社会因素比较

Table 3. Comparison of social factors between the two groups

项目	停用组(n=69)	正常组(n=117)	统计量	P值
日常社交次数(x±s，次)	2.11±0.53	3.32±1.05	8.919^a	＜0.001
独居[例(%)]			2.641^b	0.104
是	18(26.09)	19(16.24)
否	51(73.91)	98(83.76)
居住地[例(%)]			0.041^b	0.840
市区	45(65.22)	78(66.67)
郊区	24(34.78)	39(33.33)
文化程度[例(%)]			0.512^b	0.471
高中及以下	61(88.41)	99(84.62)
大学及以上	8(11.59)	18(15.38)
工作[例(%)]			5.040^b	0.025
离退休	32(46.38)	77(65.81)
无业	37(53.62)	40(34.19)
家庭收入[例(%)]			1.163^b	0.281
＜5万元	41(59.42)	62(52.99)
≥5万元	28(40.58)	55(47.01)
佩戴意愿[例(%)]			1.322^b	0.516
患者自愿	17(24.64)	34(29.06)
家属希望	30(43.48)	41(35.04)
两者均希望	22(31.88)	42(35.90)
每年外出旅游次数(x±s，次)	0.94±0.31	1.58±0.49	9.753^b	＜0.001
注：^a为t值，^b为χ²值。

下载: 导出CSV

表 4 变量赋值情况

Table 4. Assignment table of independent and dependent variables

变量	赋值方法
HHIE-S评分	连续变量，以实际值赋值
纯音听阈均值	连续变量，以实际值赋值
言语识别率	连续变量，以实际值赋值
日常社交次数	连续变量，以实际值赋值
每年外出旅游次数	连续变量，以实际值赋值
助听器价格	无(≥1.5万元)＝0，有(＜1.5万元)＝1
工作	无(无业)＝0，有(离退休)＝1

下载: 导出CSV

表 5 影响老年性聋患者助听器停用的多因素logistic回归分析

Table 5. Multivariate Logistic regression analysis of influencing hearing aid discontinuation in patients with presbycusis

变量	B	SE	Wald χ²	P值	OR值	95% CI
HHIE-S评分	0.485	0.151	10.362	0.001	1.625	1.209~2.184
纯音听阈均值	0.154	0.034	20.815	＜0.001	1.166	1.092~1.246
言语识别率	-0.198	0.040	24.996	＜0.001	0.820	0.759~0.886
助听器价格	1.135	0.576	3.889	0.049	3.112	1.007~9.618
日常社交次数	-1.284	0.339	14.355	＜0.001	0.277	0.142~0.538

下载: 导出CSV

参考文献(15)

[1]	王健艳, 谭静芊, 杨洛盈, 等. 老年性聋部分致病机制和干预的研究进展[J]. 中华耳科学杂志, 2021, 19(1): 151-156. https://www.cnki.com.cn/Article/CJFDTOTAL-ZHER202101028.htm WANG J Y, TAN J Q, YANG L Y, et al. Research progress in pathogenesis and intervention of senile deafness[J]. Chin J Ear Sci, 2021, 19(1): 151-156. https://www.cnki.com.cn/Article/CJFDTOTAL-ZHER202101028.htm
[2]	HE Z H, LI M, ZOU S Y, et al. Protection and prevention of age-related hearing loss[J]. Adv Exp Med Biol, 2019, 1103: 59-71.
[3]	SHEN Y L, YE B, CHEN P H, et al. Cognitive decline, dementia, Alzheimer' s disease and presbycusis: examination of the possible molecular mechanism[J]. Front Neurosci, 2018, 12(4): 394.
[4]	GARCÍA-ALCÁNTARA F, MURILLO-CUESTA S, PULIDO S, et al. The expression of oxidative stress response genes is modulated by a combination of resveratrol and N-acetylcysteine to ameliorate ototoxicity in the rat cochlea[J]. Hear Res, 2018, 358: 10-21. doi: 10.1016/j.heares.2017.12.004
[5]	FETONI A R, ZORZI V, PACIELLO F, et al. Cx26 partial loss causes accelerated presbycusis by redox imbalance and dysregulation of Nfr2 pathway[J]. Redox Biol, 2018, 19(3): 301-317.
[6]	黄选兆, 汪吉宝, 孔维佳. 实用耳鼻咽喉头颈外科学[M]. 2版. 北京: 人民卫生出版社, 2013: 996. HUANG X Z, WANG J B, KONG W J. Practical Otolaryngology head and Neck Surgery[M]. 2nd Ed. Beijing: People' s Medical Publishing House, 2013: 996.
[7]	张华, 王硕, 陈静, 等. 普通话言语测听材料[J]. 中国听力语言康复科学杂志, 2008(6): 16-18. doi: 10.3969/j.issn.1672-4933.2008.06.003 ZHANG H, WANG S, CHEN J, et al. Mandarin speech audiometry materials[J]. Chinese Journal of Hearing and Speech Rehabilitation, 2008(6): 16-18. doi: 10.3969/j.issn.1672-4933.2008.06.003
[8]	FUENTES-LÓPEZ E, FUENTE A, VALDIVIA G, et al. Effects of auditory and socio-demographic variables on discontinuation of hearing aid use among older adults with hearing loss fitted in the Chilean public health sector[J]. BMC Geriatrics, 2019, 19(1): 245. doi: 10.1186/s12877-019-1260-6
[9]	JAYAKODY D M P, FRIEDLAND P L, MARTINS R N, et al. Impact of aging on the auditory system and related cognitive functions: a narrative review[J]. Front Neurosci, 2018, 12(3): 125.
[10]	薄芳, 火子榕, 周杰玉, 等. 认知干预联合功能训练操对突发性耳聋患者负性情绪及生命质量的影响[J]. 中华全科医学, 2020, 18(3): 505-508, 512. doi: 10.16766/j.cnki.issn.1674-4152.001284 BO F, HUO Z R, ZHOU J Y, et al. Effects of cognitive intervention combined with functional training on negative emotion and quality of life in patients with sudden deafness[J]. Chinese journal of general practice, 2020, 18(3): 505-508, 512. doi: 10.16766/j.cnki.issn.1674-4152.001284
[11]	PUGA A M, PAJARES M A, VARELA-MOREIRAS G, et al. Interplay between nutrition and hearing loss: state of art[J]. Nutrients, 2019, 11(1): 35.
[12]	黄治物, 杨璐. 老年性聋的早期发现、诊断和预防[J]. 中华耳科学杂志, 2018, 16(3): 382-388. https://www.cnki.com.cn/Article/CJFDTOTAL-ZHER201803024.htm HUANG Z W, YANG L. Early detection, diagnosis and prevention of senile deafness[J]. Chinese Journal of Ear Science, 2018, 16(3): 382-388. https://www.cnki.com.cn/Article/CJFDTOTAL-ZHER201803024.htm
[13]	任燕, 汪琪璇, 盛海斌, 等. 老年性聋患者助听器验配效果及其影响因素[J]. 听力学及言语疾病杂志, 2020, 28(3): 312-316. https://www.cnki.com.cn/Article/CJFDTOTAL-TLXJ202003016.htm REN Y, WANG Q X, SHENG H B, et al. Effect and influencing factors of hearing aid in senile deafness patients[J]. Journal of audiology and speech diseases, 2020, 28(3): 312-316. https://www.cnki.com.cn/Article/CJFDTOTAL-TLXJ202003016.htm
[14]	于文永, 郑智英, 杨捷, 等. 老年性听力障碍病人助听器佩戴效果评估及其影响因素分析[J]. 护理研究, 2016, 30(36): 4510-4514. https://www.cnki.com.cn/Article/CJFDTOTAL-SXHZ201636010.htm YU W Y, ZHENG Z Y, YANG J, et al. Evaluation of the efficacy of hearing AIDS in patients with senile hearing impairment[J]. Nursing research, 2016, 30(36): 4510-4514. https://www.cnki.com.cn/Article/CJFDTOTAL-SXHZ201636010.htm
[15]	RUTHERFORD B R, BREWSTER K, GOLUB J S, et al. Sensation and psychiatry: linking age-related hearing loss to late-life depression and cognitive decline[J]. Am J Psychiatry, 2018, 175(3): 215-224.