慢性肾功能衰竭患者血液透析前后听功能改变
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摘要
目的分析慢性肾功能衰竭患者血液透析前后听功能情况。方法随机选取2018年6月至2018年12月就诊于潍坊市人民医院血液净化中心的慢性肾功能衰竭患者25例(50耳)作为试验对象,在血液透析开始前1h和结束后1h分别进行纯音测听检查和畸变产物耳声发射(Distortion product otoacoustic emission,DPOAE)检查,对两组数据进行统计学分析。结果 (1)血液透析前后纯音测听在0.25、0.5、1.0 kHz处平均阈值分别为(26.67±9.55)dB和(16.39±6.14)dB、(24.72±7.17)dB和(17.22±5.208)dB、(23.61±7.03)dB和(21.39±5.64)dB,差异有统计学意义(P<0.05),其余频率差异无统计学意义(P>0.05)。(2)血液透析前后DPOAE在0.7、1.0 kHz处的平均幅值分别为(-1.39±7.15)dB SPL和(3.28±7.72)dB SPL、(-4.39±12.19)dB SPL和(1.33±8.17)dB SPL,差异有统计学意义(P<0.05),其余频率幅值变化不明显(P>0.05)。(3)血液透析后DPOAE在0.7 kHz处通过率有明显提升(P<0.05)。结论透析治疗在短期内会对患者低频听功能产生正面影响,而对高频听功能的影响并不显著。
Objective To analyze the auditory function of patients with chronic renal failure before and after hemodialysis. Methods Twenty-five patients(50 ears) with renal failure who were admitted to the blood purification center of Weifang People's Hospital from June 2018 to December 2018 were randomly selected as test subjects. Pure tone audiometry and distortion product otoacoustic emission(Distortion product otoacoustic emission,DPOAE) were performed 1 hour before and 1 hour after hemodialysis. Statistical analysis of the two sets of data was performed. Results The mean thresholds of pure tone audiometry at 0.25, 0.5, and 1.0 kHz before and after hemodialysis were(26.67±9.55) dB and(16.39±6.14) dB,(24.72±7.17) dB and(17.22±5.208) dB,(23.61±7.03) dB and(21.39±5.64) dB, respectively. The difference between the comparison groups was statistically significant(P<0.05), and the difference between the other frequency comparison groups was not obvious(P>0.05). The mean amplitudes of DPOAE at 0.7 and 1.0 k Hz before and after hemodialysis were(-1.39±7.15) dB SPL and(3.28±7.72) dB SPL,(-4.39±12.19) dB SPL and(1.33±8.17), respectively. The difference between the comparison groups was statistically significant(P<0.05), and the amplitude of the remaining frequencies was not significant(P>0.05). The pass rate of DPOAE at 0.7 kHz after hemodialysis was significantly improved(P<0.05). Conclusion Dialysis treatment will have a positive impact on the low-frequency listening function of patients in the short term, but the effect on high-frequency listening function is not significant.
Objective To analyze the auditory function of patients with chronic renal failure before and after hemodialysis. Methods Twenty-five patients(50 ears) with renal failure who were admitted to the blood purification center of Weifang People's Hospital from June 2018 to December 2018 were randomly selected as test subjects. Pure tone audiometry and distortion product otoacoustic emission(Distortion product otoacoustic emission,DPOAE) were performed 1 hour before and 1 hour after hemodialysis. Statistical analysis of the two sets of data was performed. Results The mean thresholds of pure tone audiometry at 0.25, 0.5, and 1.0 kHz before and after hemodialysis were(26.67±9.55) dB and(16.39±6.14) dB,(24.72±7.17) dB and(17.22±5.208) dB,(23.61±7.03) dB and(21.39±5.64) dB, respectively. The difference between the comparison groups was statistically significant(P<0.05), and the difference between the other frequency comparison groups was not obvious(P>0.05). The mean amplitudes of DPOAE at 0.7 and 1.0 k Hz before and after hemodialysis were(-1.39±7.15) dB SPL and(3.28±7.72) dB SPL,(-4.39±12.19) dB SPL and(1.33±8.17), respectively. The difference between the comparison groups was statistically significant(P<0.05), and the amplitude of the remaining frequencies was not significant(P>0.05). The pass rate of DPOAE at 0.7 kHz after hemodialysis was significantly improved(P<0.05). Conclusion Dialysis treatment will have a positive impact on the low-frequency listening function of patients in the short term, but the effect on high-frequency listening function is not significant.
引文
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[10] 马峰杰,胡墨绳,王雷,等.20～30岁民航飞行员畸变产物耳声发射特征分析[J].航空航天医学杂志,2017,28(6):671.
[2] Peyvandi A,Roozbahany NA.Hearing Loss in Chronic Renal Failure Patient Undergoing Hemodialysis[J].Indian J Otolaryngol Head Neck Surg,2013,65(Suppl 3):S537-S540.
[3] 符涛,杨毓梅.尿毒症病人畸变产物耳声发射的临床观察[J].海南医学,2006,12(107):2.
[4] 刘大军,商惠萍,赵筱娟,等.血液透析与血液灌流联合治疗尿毒症心包积液随机对照研究[J].中国实用内科杂志,2016,36(6):476-478.
[5] Lin C,Hsu HT,Lin YS,et al.Increased risk of getting sudden sensorineural hearing loss in patients with chronic kidney disease:a population-based cohort study[J].Laryngoscope,2013,123(3):767-773.
[6] 陈雷,姜泗长,顾瑞,等.渗透压浓度变化和电刺激诱发离体耳蜗外毛细胞运动的初步观察[J].中华耳鼻咽喉科杂志,1995,30(5):219.
[7] 孙克冰,柳柯.尿毒症患者血液透析持续时间对听功能损害临床研究[J].中国实用内科杂志,2017,37(8):738.
[8] 李松杨,林顺涨,赵德美.尿毒症患者听力状况的临床研究[J].中国血液净化,2003,2(4):180-182.
[9] 李正良.血液透析对听力的影响[J].临床荟萃,1999,14(23):1064.
[10] 马峰杰,胡墨绳,王雷,等.20～30岁民航飞行员畸变产物耳声发射特征分析[J].航空航天医学杂志,2017,28(6):671.