糖尿病前期患者听力损失特点分析

发布时间：2019-05-10 04:44

【摘要】：目的比较糖尿病前期患者与健康人群间纯音测听、畸变产物耳声发射(DPOAE)和听性脑干反应(ABR)的差异,了解糖尿病前期患者是否存在听力损失,并分析糖尿病前期患者听力损失特点。方法根据口服葡萄糖耐量试验(OGTT)连续入组年龄小于60岁的糖尿病前期患者50例,并选取50例同期年龄、性别匹配,OGTT血糖结果正常的健康体检人群作为对照组。收集受试者身高、体重等一般资料,并记录OGTT空腹及糖负荷后2 h血糖、糖化血红蛋白、尿白蛋白/肌酐比值、血脂和眼底像等结果。于耳鼻喉科检查室行纯音测听、声导抗、DPOAE和ABR检查,并记录相关参数,包括气、骨导纯音听阈、DPOAE反应幅值及ABR潜伏期。结果纯音测听检查中,糖尿病前期组25例(50%),对照组6例(12%)患者存在听力损失,两组差异有统计学意义(P0.001)。各频率(250、500、1 000、2 000、4 000、8 000Hz)纯音听阈糖尿病前期组均较对照组升高,在4 000、800Hz频率两组差异有统计学意义(P0.001)。听力损失表现为双侧对称性气、骨导听阈同步升高,气、骨导差异小于10d B。DPOAE检查显示糖尿病前期组全频率反应幅值下降,与对照组比较在1 000、1 500、2 000、3 000、4 000、6 000 Hz差异有统计学意义(P0.001)。ABR检查中,糖尿病前期组与对照组比较未见潜伏期延长,差异无统计学意义。结论糖尿病前期患者存在听力损失,呈亚临床表现;糖尿病前期患者的听力损失表现为双侧对称性感音神经性听力损失,以高频听力受损为主;糖尿病前期听力损失主要部位为耳蜗,表现为外周听觉器官障碍,尚未发现听觉中枢异常。
[Abstract]:Objective to compare the differences of pure tone audiometric, distortion product otoacoustic emission (DPOAE) and auditory brainstem response (ABR) between patients with prediabetes mellitus and healthy people, and to investigate whether there is hearing loss in patients with prediabetes mellitus. The characteristics of hearing loss in prediabetic patients were analyzed. Methods according to oral glucose tolerance test (OGTT), 50 prediabetic patients less than 60 years old were enrolled in the group, and 50 healthy people with age, sex matching and normal OGTT blood glucose results were selected as the control group. The general data of height and weight of the subjects were collected, and the results of fasting blood glucose, glycosylated hemoglobin, urinary albumin / creatine ratio, blood lipid and fundus image were recorded at fasting and 2 h after glucose load in OGTT. Pure tone audiometry, acoustic immittance, DPOAE and ABR were performed in the otorhinolaryngology examination room, and the related parameters, including air, bone conduction pure tone hearing threshold, DPOAE response amplitude and ABR latency, were recorded. Results in pure tone audiometric examination, there were 25 cases (50%) in prediabetic group and 6 cases (12%) in control group. There was significant difference between the two groups (P0.001). The frequency of pure tone hearing threshold in prediabetic group (250, 500, 1 000, 4 000, 8 000Hz) was higher than that in control group, and the frequency of pure tone hearing threshold in 4 000800Hz group was significantly different from that in control group (P0.001). The hearing loss showed bilateral symmetrical gas, the hearing threshold of bone conduction increased synchronously, and the difference between qi and bone conduction was less than 10 days. B.DPOAE showed that the amplitude of full frequency response decreased in prediabetes group. Compared with the control group, there was significant difference in 1 000, 1 500, 3 000, 4 000, 6 000 Hz between the prediabetic group and the control group (P0.001). There was no significant difference in the incubation period between the prediabetic group and the control group, but there was no significant difference between the pre-diabetic group and the control group. Conclusion there are subclinical manifestations of hearing loss in patients with prediabetes mellitus, and the hearing loss in patients with prediabetes mellitus is bilateral symmetrical sensorineural hearing loss, mainly high frequency hearing loss. The main part of hearing loss in prediabetes mellitus was cochlea, which showed peripheral auditory organ impairment, and no abnormal auditory center was found.
【作者单位】：首都医科大学附属复兴医院内分泌科;
【基金】：北京市教委科技计划面上项目(编号:KM201610025020) 首都卫生发展科研专项(编号:首发2016-2-7022) 首都医科大学附属复兴医院青年基金项目(编号:2014YQN03)
【分类号】：R587.1;R764

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