多囊卵巢综合征患者听损伤特点及影响因素研究

背景已有研究证实多囊卵巢综合征（PCOS）患者存在听损伤，但关于PCOS患者听损伤的影响因素未得到充分阐释。目的探究PCOS患者听损伤特点并分析其影响因素。方法选取2018年3月至2021年2月苏州市第九人民医院妇科确诊的PCOS患者203例（406耳）为PCOS组，选取同期本院30例体检健康女性（60耳）为对照组。比较两组的听力学检查结果。采用多因素Logistic回归分析探讨PCOS患者听损伤影响因素。结果PCOS组中低频（0.25~2.00 kHz）听阈值与对照组比较，差异无统计学意义（P>0.05）；PCOS组高频（4.00 kHz、8.00 kHz）和扩展高频（10.00~20.00 kHz）听阈值均高于对照组（P<0.05）。203例PCOS患者听阈测试中听损伤者占25.62%（52/203）。PCOS患者病程越长，其听损伤发生率越高、损伤程度越重（χ2趋势=42.475，P<0.001）。PCOS患者中伴有听损伤患者胰岛素抵抗发生率低于非听损伤患者（χ2=12.765，P<0.001）；伴有听损伤PCOS患者的C反应蛋白（CRP）、同型半胱氨酸（Hcy）、空腹血糖（FBG）、三酰甘油（TG）均高于非听损伤患者（t=2.490、2.819、2.419、4.436，P<0.05）。多因素Logistic回归分析显示，病程和胰岛素抵抗、CRP、Hcy、FBG、TG是PCOS患者听损伤的影响因素（P<0.001）。结论PCOS患者的病程和胰岛素抵抗、CRP升高、高血糖、Hcy高表达、血脂异常是PCOS患者听损伤的影响因素，临床应根据各诱因采取措施来防止或延缓PCOS患者听损伤的发生与发展。

Analysis of Characteristics and Influencing Factors of Hearing Impairment in Patients with Polycystic Ovary Syndrome

Background Hearing impairment in patients with polycystic ovary syndrome(PCOS)has been confirmed,However,the influencing factors of hearing impairment in PCOS patients have not been fully explained.Objective To explore the characteristics of hearing impairment in patients with PCOS and analyze its influencing factors.Methods 203 PCOS patients(406 ears)diagnosed in the Department of Gynecology,Suzhou Ninth People's Hospital from March 2018 to February 2021 were selected as the PCOS group.At the same time,30 healthy women(60 ears)were selected as the control group.The audiology examination results of the two groups were compared.Logistic regression analysis was used to explore the influencing factors of hearing impairment in PCOS patients.Results Compared with the control group,there was no statistically significant difference in the hearing threshold of PCOS patients with low and medium frequencies(0.25-2.00 kHz)(P>0.05).The hearing thresholds of high frequency(4.00 kHz,8.00 kHz)and extended high frequency(10.00-20.00 kHz)in the PCOS group were higher than those in the control group(P<0.05).Auditory impairment accounted for 25.62%(52/203)in the auditory valve test of 203 PCOS patients.The longer the course of PCOS,the higher the incidence and severity of hearing impairment(χ²_( trend)=42.475,P<0.001).The incidence of insulin resistance in PCOS patients with hearing impairment was significantly lower than that in patients without hearing impairment(χ²=12.765,P<0.001);the C-reactive protein(CRP),homocysteine(Hcy),fasting blood glucose(FBG),and triacylglycerol(TG)indexes of PCOS patients with hearing impairment were higher than those of non-hearing impairment patients(t=2.490,2.819,2.419,4.436,P<0.05).Logistic regression analysis showed that the course of disease and insulin resistance,CRP,Hcy,FBG,TG indicators are all influencing factors of hearing impairment in PCOS patients(P<0.001).Conclusion The course of the disease and insulin resistance,elevated CRP,high blood sugar,high expression of Hcy,and dyslipidemia in PCOS patients are the influencing factors of hearing impairment in PCOS patients.Clinical measures should be taken according to various incentives to prevent or delay the occurrence and development of hearing loss in PCOS patients.