尿毒症患者听力状况及其影响因素研究

目的观察尿毒症患者的听力状况，探讨引起尿毒症患者听力下降的原因。方法采用纯音测听和高刺激率ABR对30例（60耳）尿毒症患者及31例（62耳）非尿毒症者进行测试，用SPSS19．0软件进行统计分析。结果30例尿毒症患者中有26例伴有不同程度的听力下降，其中19例听力曲线为下降型，5例为平坦型，2例为单侧全聋和另侧下降型。尿毒症组内纯音测听结果与肌酐水平无相关（P〉0．05）。与尿素氨水平为负相关（P=0．011），高刺激率ABR与纯音测听结果无相关（P〉0．05）。尿毒症组和对照组间高刺激率ABR波I～V潜伏期的差值有统计学意义（P〈0．05）。结论尿毒症患者的听力下降是以高频为主的下降型曲线，内耳血供不足是导致尿毒症患者听力障碍的一个主要因素。

The Hearing Status of Uremic Patients and Related Influencing Factors

Objective To investigate the hearing causes of hearing loss in these patients. Methods Th conditions of uremic patients and the rty patients （60 ears） with uremia and thirty-one normal-hearing controls （62 ears） received the pure-tone audiometry and auditory brainstem responses （ABR）at high stimulus rates. The results of the two groups were analyzed by SPSS19.0 software. Results Among the uremic group, 26 patients showed different degrees of hearing loss, including 19 cases with descending audiometric curves, 5 cases with flat curves, 2 cases with complete deafness on one side and sloping loss on the other side. The pure-tone test results were not related to the creatinine level and high-stimulus ABR results （P〉0.05）, but negatively related to the urea nitrogen level （P=0.011）. There was a significant difference in ABR wave I -V incubation period （P〈0.05） between the uremic group and the control group（P〈0.05）. Conclusion The audiometric curve of uremic patients is mainly the high-frequency descending type. The inner ear ischemia may be the maior cause of hearing loss in uremic patients.