单句询问与中文版老年听力障碍筛查量表在社区50岁以上人群听力筛查中的应用

目的：探讨中文版老年听力障碍筛查量表（Chinese version of hearing handicap inventory for the eld-erly－screening ，中文版 HHIE－S）和单句询问应用于社区50岁以上人群听力筛查的意义。方法使用中文版HHIE－S 量表及单句询问“您现在觉得听力有问题吗？”两种方法对某社区570例50～85岁中、老年人进行听力筛查，以0．5、1、2、4 kHz 平均纯音听阈（pure－tone audiometry，PTA）作为金标准，分别在 PTA ＞25、＞40、＞60 dB HL 三种不同听力损失分级条件下，计算单句询问及中文版 HHIE－S 量表的敏感性、特异性、阳性预测值及阴性预测值，比较两种方法对不同程度听力损失者的检出能力。结果570例中，PTA＞25 dB HL 478例，占83．86％，中文版 HHIE－S 量表＞8分者315例，占55．46％，单句询问阳性者299例，占52．46％。在三个不同听力损失分级条件下中文版 HHIE－S 量表＞8分的敏感性分别为61％、85％、96％，特异性分别为72％、58％、47％，单句询问阳性组的敏感性为58％、81％、100％，特异性为75％、61％、50％，两种听力筛查方法经统计分析比较差异无统计学意义（P ＞0．05）。结论中文版 HHIE－S 量表与单句询问方法对中重度听力损失中、老年人的筛查都有较高的敏感性，可根据研究目的用于临床及基层大样本中、老年人群的听力筛查。

Comparison of the Performance between the Mandarin Version of HHIE-S and Single Question in the Hearing Screening in Old Adults

Objective To compare the performance of Mandarin screening version of hearing handicap inven-tory in elderly (HHIE-S)and the single question of hearing loss in the hearing screening in the old adults.Methods A total of 570 participants,aged from 50~85 years,of native Mandarin speakers were tested with standard pure tone audiometry (PTA),HHIE-S and single question"Are you now having difficulty in hearing?".HHIE-S>8 was taken as an indicator of hearing handicap.Sensitivity,specificity,negative predictive values and positive predic-tive values of both HHIE-S and single question inquiry when 0.5~4 kHz PTA average > 25 dB,>40 dB and >60 dB were compared.Results The prevalence was 83.9% (478)measured by PTA.The prevalence was 55.3%and 52.5% for HHIE-S and positive answer for single question,respectively.The sensitivity of HHIE-S when the participants grouped with 0.5~4 kHz PTA average > 25 dB,>40 dB and > 60 dB was 61%,85% and 96%, respectively,whereas the sensitivity of single question of the above 3 conditions was 58%,81% and 100%,respec-tively.The specificity of HHIE-S decreased with greater hearing loss.It was 72%,88% and 47% respectively for HHIE-S and 75%,61% and 50% for the single question.There was no significant difference either for sensitivity and specificity between the HHIE-S and the single question.Conclusion Both the Mandarin version of HHIE-S and single question are effective in the hearing screening of old adults.Depending on the purpose and availability of resources,one or both of them can be adopted.