耳科正常中国人听阈偏差值统计分布表构建的初步研究

A preliminary study on developing statistical distribution table of hearing threshold deviation for otologically normal Chinese adults

  • 摘要:
    背景 噪声性听力损失的评估主要依据ISO 7029-2017标准(ISO 7029)的听阈统计分布表,该标准基于国外人群数据构建,缺乏基于中国人群纯音测听数据构建的听阈统计分布表,难以精准评估中国人群的听力损失情况。
    目的 初步构建耳科正常中国人的听阈水平(HTL)统计分布表,为我国职业性噪声聋诊断标准的修订提供科学依据。
    方法 将18~60岁1271名耳科正常中国人群以10岁为年龄段分为4组,通过纯音测听数据,基于幂函数计算公式,重新调整ISO 7029的中位数与百分位数计算公式的相关参数,以调整后参数为基础,依据ISO 7029的计算公式,初步构建耳科正常中国人HTL的统计分布表,并通过非参数秩和检验比较调整后的听阈偏差值中位数与ISO 7029差异。
    结果 除少数频率(200030008000 Hz)外,经中国人群听阈偏差值调整后的参数ααCHN-md)取值随频率的升高而增大,经中国人群听阈偏差值调整后的参数ββCHN-md)取值随频率的升高而降低。初步构建的耳科正常中国人听阈偏差值中位数(ΔHCHN-md)分布表显示,听阈偏差值随着年龄和频率的增加而升高,在8000 Hz频率下男性和女性的ΔHCHN-md随年龄增长值最大,分别从0 dB增至23 dB和21 dB。而在500和10002000 Hz频率下,ΔHCHN-md随年龄增长值最小,从0 dB增至2 dB。在耳科正常中国人群中,50岁时ΔHCHN-md随频率的增长值最大,男性从500 Hz的2 dB增长至8000 Hz的23 dB,女性从500 Hz的2 dB增长至8000 Hz的21 dB。与ISO 7029比较,趋势具有一致性,经耳科正常中国人群调整后的听阈偏差值中位数整体低于ISO 7029的听阈偏差值中位数(ΔHmd),但两者之间不存在统计学差异(P>0.05)。对于耳科正常的中国男性和女性,50岁组在8000 Hz频率下与ISO 7029的ΔHmd的取值差异最大,分别为7 dB和9 dB。
    结论 本研究针对我国耳科正常人群听阈偏差值的初步分析表明,现行标准在8000 Hz以下频段可能存在听力损失低估倾向,而在8000 Hz频段则可能呈现高估现象。上述发现仍需通过扩大样本规模,以更准确地评估我国人群的听阈特征及其与现行标准的差异。

     

    Abstract:
    background Current assessment of noise-induced hearing loss relies on the hearing threshold statistical distribution table of ISO 7029-2017 standard (ISO 7029), which is based on foreign population data and lacks a hearing threshold distribution table derived from pure-tone audiometry data of the Chinese population, hindering accurate evaluation of hearing loss in this group.
    Objective To establish a statistical distribution table of hearing threshold level (HTL) for otologically normal Chinese adults and to provide a scientific basis for revising the diagnostic criteria of occupational noise-induced deafness in China.
    Methods A total of 1271 otologically normal Chinese adults aged 18-60 years were divided into four groups with 10-year age intervals. Based on the pure tone audiometry data and power function operation formula, the relevant parameters of the median and percentile calculation formula of ISO 7029 were adjusted. Based on the adjusted parameters, a statistical distribution table of HTL of normal Chinese adults in otology was preliminarily constructed according to the calculation formula of ISO 7029. A nonparametric rank sum test was used to compare the difference between the adjusted median deviation value and the ISO 7029 calculation.
    Results Except for a few frequencies (2000, 3000, and 8000 Hz), the value of parameter α adjusted for the auditory threshold deviation of the Chinese population (αCHN-md) increased with the increase of frequency, while the value of parameter β adjusted for the auditory threshold deviation of the Chinese population (βCHN-md) decreased with the increase of frequency. The preliminary distribution table of otologically normal Chinese adults' median hearing threshold deviation (ΔHCHN-md) showed that the hearing threshold deviation increased with age and frequency. At 8000 Hz, the increase in ΔHCHN-md with age was the greatest for both men and women, from 0 dB to 23 dB and 21 dB respectively. The minimal threshold elevation was noted at 500, 1000, and 2000 Hz, which increased from 0 dB to 2 dB. In otologically normal Chinese adults, the maximum increase of ΔHCHN-md with frequency was observed at age of 50 years, which increased from 2 dB at 500 Hz to 23 dB at 8000 Hz in men and from 2 dB at 500 Hz to 21 dB at 8000 Hz in women. The comparison results with the ISO 7029 calculation showed that the trend was consistent. The median hearing threshold deviation value of the adjusted Chinese population was lower than that of the ISO 7029 calculation (ΔHmd). However, they had no significant statistical difference (P>0.05). For otologically normal normal Chinese men and women, the maximum difference of ΔHmd between the 50-year-old group and the ISO calculation at 8000 Hz was 7 dB and 9 dB, respectively.
    Conclusion This preliminary analysis of hearing threshold deviations in otologically normal Chinese adults suggests that current standards may potentially underestimate hearing loss at frequencies below 8000 Hz while possibly overestimating it at 8000 Hz. These findings require further validation through expanded sample sizes to more accurately assess the characteristics of hearing thresholds in the Chinese population and their discrepancies with existing standards.

     

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