周围听功能障碍与认知障碍程度的相关性研究

目的探讨周围性听功能障碍程度与认知障碍程度之间的关系。方法利用临床痴呆量表(clinicdementiarating, CDR)检测轻度认知障碍(mildcognitiveimpairment,MCI)患者24例,轻度老年性痴呆(Alzheimer′sdisease, AD)患者31例,健康老年人50例,评定受试者测听可信度,统计测试结果,并将其得分同受试者的纯音测听、言语测听、声导抗、听觉脑干反应(auditorybrainstemresponse, ABR)结果进行对照分析,寻找二者之间的关系。并进一步将受试者按其听力损失程度分成4级(纯音听阈<25dB为0分, 25~30dB为1分, 31~35dB为2分, >35dB为3分),分别依其CDR得分不同(正常人0分,MCI患者0 5分,轻度AD患者1分),应用Kendalls等级相关法分析。结果受试者2耳间听力差异无统计学意义,以右耳听力结果进行统计,发现MCI组周围听功能检查结果与对照组之间的差异无统计学意义(P>0 05),轻度AD组听力障碍与其他两组相比差异有统计学意义,且发现随着听力损失的加重,轻度AD患者的CDR得分也明显增加(Kendallstaub=-0 285, P=0 018)。而测听可信度、声导抗和ABR阈值两组间差异无统计学意义(P>0 05 )。结论MCI患者与正常老年聋纯音测听、言语测听结果相似,轻度AD患者与MCI及正常对照组相比差异有显著性,受试者听力障碍程度与其CDR量表得分呈正相关(

Hearing impairment in patients with mild cognitive impairment and Alzheimer′s disease

OBJECTIVE: To study the relationship between the degrees of peripheral auditory dysfunction and clinical dementia rating (CDR) in the patients with mild cognitive impairment (MCI) and Alzheimer's disease (AD). METHODS: Pure-tone thresholds (PT), word recognition scores (WRS), acoustic immittance and auditory brain-stem responses (ABR) were done to evaluate the auditory function in 24 cases of the patients with MCI and in 31 cases of the patients with AD and in 50 subjects of the control group. Clinical dementia rating (CDR) questionaire was used to define the dementia degree of the subjects. RESULTS: Twenty-four MCI patients and 31 AD patients were selected, with average age of 72.0 +/- 6. 5 and 73.1+/-7. 5 of whom 70.8% and 67.7% were female separately. There was no significant difference in PTT and WRS between the MCI and AD groups (P > 0.05). In order to ascertain the relationship between hearing level and degree of dementia, all subjects were divided into 4 groups according their hearing loss (PTA <25 dB:0, 25-30 dB:1, 31-35 dB:2, >35 dB:3) to compare their CDR scores (the control:0, MCI:0. 5, mild AD:1). The more the CDR scores have, the more hearing impairment after controlling the confounder factors (Kendalls tau b = - 0.285, P = 0.018). No significant difference was found between the two groups in audiometry reliability, acoustic immittance and ABR (P > 0.05). CONCLUSION: The positive relationship was founded the peripheral hearing impairment and the score of CDR questionaire in less than 0.5 score of CDR groups and mild AD patients.