慢性鼻窦炎患者耳鸣与头痛严重程度及环境噪声暴露水平之间的相关性分析

文献信息

中文摘要

目的： 本研究旨在探讨慢性鼻窦炎（CRS）患者居住环境噪声暴露水平与其耳鸣和头痛强度之间的关系。
方法： 本横断面研究纳入100例CRS患者以及100名按年龄、性别和噪声暴露水平匹配的健康对照。我们通过连续7天记录的等效连续A计权声压级（Leq）来量化环境噪声暴露。根据Leq读数，受试者被分为三个暴露层级：低（≤55 dB[A]）、中（55.01-65 dB[A]）和高（≥65.01 dB[A]）。我们使用耳鸣致残量表（THI）测量耳鸣严重程度，并使用视觉模拟量表（VAS）测量头痛严重程度。统计分析包括Spearman秩相关和多因素logistic回归。
结果： 在CRS患者中，THI和VAS评分随噪声暴露水平升高而逐渐增加（F=377.12和134.25，均P<0.001）。噪声暴露水平与THI（r=0.712）和VAS（r=0.689）评分呈强正相关（均P<0.001）。多因素分析确定高水平噪声暴露（比值比[OR]=4.215，95%置信区间[CI]：1.987-8.942，P<0.001）和病程≥5年（OR=2.876，95% CI：1.235-6.718，P=0.014）为严重耳鸣的独立危险因素。高水平噪声暴露（OR=3.987，95% CI：1.896-8.385，P<0.001）和吸烟（OR=2.135，95% CI：1.024-4.451，P=0.043）为严重头痛的独立危险因素。亚组分析显示，病程较长的患者中相关性更强。
结论： 在CRS患者中，居住环境噪声暴露水平与耳鸣和头痛严重程度呈正相关。高水平噪声暴露是严重耳鸣和严重头痛的独立危险因素。

英文摘要

OBJECTIVE: This study aimed to explore the relationship between the level of noise exposure in patients' residential environments and the intensity of tinnitus and headache among individuals with chronic rhinosinusitis (CRS).
METHODS: This cross-sectional study included 100 patients with CRS alongside 100 healthy controls matched by age, sex, and noise exposure levels. We quantified ambient noise exposure using the equivalent continuous A-weighted sound pressure level (Leq), recorded over a 7‑day period. Based on their Leq readings, subjects were classified into three exposure tiers: low (≤55 dB[A]), moderate (55.01-65 dB[A]), and high (≥65.01 dB[A]). We used the Tinnitus Handicap Inventory (THI) to measure tinnitus severity and a Visual Analog Scale (VAS) to measure headache severity. Statistical evaluations included Spearman's rank correlation and multivariate logistic regression.
RESULTS: In patients with CRS, THI and VAS scores increased progressively with higher noise exposure levels ( F  = 377.12 and 134.25, both P < 0.001). Noise exposure level showed strong positive correlations with THI ( r  = 0.712) and VAS ( r  = 0.689) scores (both P < 0.001). Multivariate analysis identified high-level noise exposure (odds ratio [OR] = 4.215, 95% confidence interval [CI]: 1.987-8.942, P < 0.001) and disease duration ≥5 years (OR = 2.876, 95% CI: 1.235-6.718, P  = 0.014) as independent risk factors for severe tinnitus. High-level noise exposure (OR = 3.987, 95% CI: 1.896-8.385, P < 0.001) and smoking (OR = 2.135, 95% CI: 1.024-4.451, P  = 0.043) were independent risk factors for severe headache. Subgroup analysis revealed stronger correlations in patients with longer disease duration.
CONCLUSION: In patients with CRS, residential noise exposure level is positively correlated with tinnitus and headache severity. High-level noise exposure is an independent risk factor for severe tinnitus and severe headache.