老年感音神经性听力损失患者噪声下词语识别与感知听力障碍及生活质量的关系

文献信息

中文摘要

背景/目的： 纯音测听和安静条件下获得的词语识别得分（WRS）可能无法完全反映日常听力困难。本研究探讨不同聆听条件下的WRS与老年感音神经性听力损失患者感知听力障碍及生活质量的关系，并检验其在人口学和听力学变量之外是否能够解释感知障碍。
方法： 纳入79名老年感音神经性听力损失患者。采用同侧言语噪声，在安静条件下以及+10 dB和0 dB信噪比（SNR）条件下评估WRS。分别使用土耳其老年听力障碍量表（HHIE）和世界卫生组织生活质量-老年人模块（WHOQOL-OLD）评估感知听力障碍和生活质量。聆听条件比较采用Friedman检验和Bonferroni校正的Wilcoxon检验。关联采用Spearman相关分析，分层回归评估在校正年龄、纯音平均听阈、听力损失病程和耳鸣后WRS的独立贡献。
结果： WRS从安静条件下的88%降至+10 dB SNR的72%和0 dB SNR的32%（p < 0.001）。较低的WRS与更严重的听力障碍相关，在0 dB SNR时关联最强（r = -0.491，p < 0.001），而与总体生活质量未见显著关联。在人口学和听力学变量之外，两种噪声下言语条件对HHIE总分的额外方差解释量相似（+10 dB SNR，ΔR2 = 0.037，p = 0.054；0 dB SNR，ΔR2 = 0.042，p = 0.039）。
结论： 噪声下词语识别比安静条件下表现更能反映感知听力障碍。噪声下言语识别可作为听力特异性自报测量工具的补充，用于评估日常听力困难。

英文摘要

BACKGROUND/OBJECTIVES: Pure-tone audiometry and word recognition scores (WRS) obtained in quiet may not fully reflect everyday hearing difficulties. This study examined how WRS across different listening conditions relate to perceived hearing handicap and quality of life in older adults with sensorineural hearing loss, and whether they explain perceived handicap beyond demographic and audiological variables.
METHODS: Seventy-nine older adults with sensorineural hearing loss were included. WRS were assessed in quiet and at +10 dB and 0 dB signal-to-noise ratios (SNRs) using ipsilateral speech noise. Perceived hearing handicap and quality of life were evaluated using the Turkish Hearing Handicap Inventory for the Elderly (HHIE) and World Health Organization Quality of Life-Older Adults Module (WHOQOL-OLD), respectively. Listening conditions were compared using Friedman and Bonferroni-corrected Wilcoxon tests. Associations were examined with Spearman correlations, and hierarchical regression assessed the independent contribution of WRS after adjustment for age, pure-tone average, hearing loss duration, and tinnitus.
RESULTS: WRS decreased from 88% in quiet to 72% at +10 dB SNR and 32% at 0 dB SNR (p < 0.001). Lower WRS was associated with greater hearing handicap, most strongly at 0 dB SNR (r = -0.491, p < 0.001), while no significant association was observed with overall quality of life. Both speech-in-noise conditions explained a similar amount of additional variance in HHIE total scores beyond demographic and audiological variables (+10 dB SNR, ΔR2 = 0.037, p = 0.054; 0 dB SNR, ΔR2 = 0.042, p = 0.039).
CONCLUSIONS: Word recognition in noise reflected perceived hearing handicap better than performance in quiet. Speech recognition in noise may complement hearing-specific self-report measures in evaluating everyday hearing difficulties.