老年性聋患者普通话快速噪声下言语测试及评估

目的评估老年性聋患者噪声下言语识别能力,探讨年龄、听力损失程度、认知功能对其噪声下言语识别能力的影响。方法选取2018年10月~2020年4月就诊的70例60岁及以上老年性聋患者为研究对象,按年龄分为60~69岁(20例40耳)、70~79岁(28例56耳)、≥80岁(22例44耳)三组,各组分别进行纯音听阈测试、简易智能精神状态量表(mini-mental state examination,MMSE)评估及普通话快速噪声下言语测试(Mandarin quick speech-in-noise test,M-Quick SIN),分别获得双耳0.5、1、2、4 kHz纯音平均听阈(pure-tone audiometry,PTA)、MMSE量表总得分及双耳信噪比损失(signal-to-noise ratio loss,SNR loss);分析年龄、平均听阈、MMSE量表得分对信噪比损失的影响。结果①60~69岁组SNR loss(5.25±5.42)dB明显小于70~79岁组(11.54±6.05)dB和≥80岁组(11.86±6.06)dB(P<0.01);70~79岁组和≥80岁组间SNR loss差异无统计学意义(P>0.05)。②SNR loss随PTA提高而升高,各组间差异均有显著统计学意义(P<0.01)。③MMSE量表得分对SNR loss的主效应不显著(P>0.05)。结论年龄、听力损失程度为老年性聋患者噪声下言语识别的主要影响因素;在一定范围内随着年龄增加,听力损失加重,其噪声下言语识别能力降低。

The Evaluation of Mandarin Quick Speech-in-noise Test in Patients with Presbycusis

Objective To evaluate the speech recognition under noise in patients with presbycusis by Mandarin quick speech-in-noise test(M-Quick SIN),and to discuss the effects of age,hearing loss and cognitive function on speech recognition.Methods A total of 70 older patients aged over 60 years were selected as subjects,which were divided into three groups according to age,60~69 years old(40 ears),70~79 years old(56 ears)and≥80 years old(44 ears).All the participants completed pure-tone audiometry(PTA),the mini-mental state examination(MMSE),and the Mandarin quick speech-in-noise test(M-Quick SIN).The pure-tone average hearing threshold of 0.5,1,2,4 kHz(PTA),MMSE score and signal-to-noise ratio loss(SNR loss)were obtained and analyzed the correlation among age,PTA,MMSE score and SNR loss.Results①The SNR loss(5.25±5.42)dB was significantly higher in the 60~69 age group than in the 70~79 age group(11.54±6.05)dB and in the≥80 age group(11.86±6.06)dB(P<0.01);but there was no significant difference in SNR loss between 70~79 age group and≥80 age group(P>0.05).②The SNR loss increased with the PTA,and the difference between three groups was statistically significant(P<0.01).③Main effects of MMSE scores on the SNR loss were not significant(P>0.05).Conclusion Age and hearing loss can influence the speech recognition under noise in patients with presbycusis,and the speech recognition under noise would reduce with the increase of age and hearing loss.