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目的 比较合并中耳炎的老年性聋患者与单纯老年性聋患者的认知功能水平，探讨合并中耳炎的老年性聋患者外科治疗后认知功能是否改善，并分析认知功能改善的相关因素。方法 选取2020年9月至2024年3月就诊北京清华长庚医院的70例单纯老年性聋患者和70例合并中耳炎的老年性聋患者，两组患者均行纯音测听、蒙特利尔认知评估量表（Montreal cognitive assessment,MoCA）评分，以独立样本秩和检验分析两组间数据差异。进一步对合并中耳炎的老年性聋患者行鼓室成形术，患者术前、术后3个月和术后6个月均行纯音测听、最大言语识别率、耳鸣残疾评估量表评分、耳溢液频次和MoCA评分，以独立/配对样本秩和检验分析术前、术后各组数据差异，以Spearman秩相关检验和多因素线性回归分析认知功能改善的相关因素。结果 合并中耳炎的老年性聋患者MoCA总分[23.5(21,25)分]低于单纯老年性聋患者MoCA总分[26(24,27)分]，且存在统计学差异（P<0.05）。对合并中耳炎的老年性聋患者行鼓室成形术，MoCA总分术后3个月[24(22,26)分]和术后6个月[25(23,27)分]均高于术前[23.5(21,25)分]，且存在统计学差异（P<0.05）。综合对影响MoCA评分变化的多因素分析，术后3个月和术后6个月MoCA得分提高与听力改善和耳溢液频次改善有关（P<0.05）。结论 合并中耳炎的老年性聋患者可能存在更加明显的认知功能下降；鼓室成形术可能通过减少或消除传导性听力损失及耳溢液频次，从而改善合并中耳炎的老年性聋患者的认知功能。
Abstract：Objective To report cognitive function levels of patients with presbycusis and otitis media after surgical treatment as compared to those with presbycusis only, as well as factors affecting cognitive function improvement. Methods From September 2020 to March 2024, patients with presbycusis and otitis media(n=70) and patients with presbycusis only(n=70) pure underwent pure tone audiometry(PTA) and completed the Montreal Cognitive Assessment(MoCA) survey at Beijing Tsinghua Changgung Hospital, The differences between the two groups was analyzed using independent sample rank sum test. Tympanoplasty was performed on patients with otitis media. PTA, maximum speech discrimination scores(SDSmax), Tinnitus Disability Inventory(THI) scores, frequency of ear discharge and MoCA scores were completed before and 3 and 6 months after surgery. Independent/Paired sample rank sum test was used to compare preoperative and postoperative data in both groups. Spearman rank correlation test and multiple factor linear regression were used to identify factors influencing cognitive function improvement. Results The total Mo CA score is lower in patients with presbycusis and otitis media [23.5(21, 25)] than in those with presbycusis only [26(24, 27)](P<0.05). In patients with presbycusis and otitis media, the total MoCA scores at 3 months [24(22, 26)] and 6 months [25(23, 27)] after tympanoplasty surgery were higher than before surgery [23.5(21, 25)](P<0.05). An increase in the MoCA score at 3 and 6 months after surgery was associated with improvement in hearing and frequency of ear discharge(P<0.05). Conclusions Patients with presbycusis and otitis media may have more significant cognitive decline. Tympanoplasty may improve cognitive function in these patients by reducing or eliminating conductive hearing loss and ear discharge.
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基本信息:
中图分类号:R764.21;R764.436
引用信息:
[1]陈俊言,郭翔,梁思超,等.合并中耳炎的老年性聋患者外科治疗后认知功能变化研究[J].中华耳科学杂志,2026,24(01):14-19.
2026-01-12
2026-01-12