Longitudinal threshold changes in older men with audiometric notches
Longitudinal threshold changes in older men with audiometric notches
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DOI：
10.1016/s0378-5955(99)00223-3
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发表时间：
2000-03-01
期刊：
影响因子：
2.8
通讯作者：
D'Agostino, R
中科院分区：
文献类型：
--
作者：
Gates, GA;Schmid, P;D'Agostino, R
噪声相关性听力损失（老年性耳聋）是一个多因素的过程，主要是由于噪声损伤和老化对耳蜗的累积影响。噪声损伤通常在临床上通过听力图的3-6 kHz区域中的听觉阈值的离散升高（陷波）来证明，而老化首先影响最高频率。为了确定这种高频陷波的存在是否会影响听觉老化，我们检查了来自心脏研究队列的203名男性的听力阈值的15年变化。首次听力测试的平均年龄为64岁（范围58-80）。由于受试者的年龄，15年来的职业和娱乐噪声暴露被认为是最小的。使用分段线性/抛物线曲线拟合策略确定是否存在缺口。在3-6 kHz范围内，纯音阈值离散升高15-34 dB被视为小陷波（N1），升高35 dB或更大被视为大陷波（N2）。在3-6 kHz区域内，缺失切迹（NO）被编码为具有< 15 dB升高的那些耳。有无刻痕与受试者的噪声暴露史相关。年龄调整纯音听阈的15年变化模式因切迹类别而异。与NO组和N1组相比，N2组的陷波频率（3-6 kHz）随时间的变化较小，相邻频率2 kHz的变化显著较大。与NO和N2组相比，N1组的相邻频率8 kHz显示出显著但较小的变化。2 kHz的变化与E15时的起始听力水平无关，而4-8 kHz的变化受E15时听力水平的影响。这些数据表明，噪声损伤的耳朵不会以与非噪声损伤的耳朵相同的速度“老化”。在2 kHz时损失增加的发现表明，噪声损伤的影响可能在噪声暴露停止后很长时间内仍会持续。这一发现的机制尚不清楚，但可能是由于先前的噪音引起的耳蜗损伤。(C)2000 Elsevier Science B. V.保留所有权利。
Age-related hearing loss (presbycusis) is a multifactorial process that results chiefly from the accumulating effects of noise damage and aging on the cochlea. Noise damage is typically evidenced clinically by a discrete elevation (notch) of the auditory thresholds in the 3-6 kHz region of the audiogram whereas aging affects the highest frequencies first. To determine whether the presence of such high-frequency notches influences auditory aging, we examined the 15 year change in audiometric thresholds in 203 men from the Framingham Heart Study cohort. The mean age at the first hearing test was 64 years (range 58-80). Occupational and recreational noise exposure over the 15 years was assumed to be minimal due to the age of the subjects. The presence or absence of a notch was determined using a piecewise linear/parabolic curve fitting strategy. A discrete elevation of the pure-tone thresholds of 15-34 dB in the 3-6 kHz region was deemed a small notch (N1), and elevations of 35 dB or greater were deemed large notches (N2). Absence of a notch (NO) was encoded those ears with < 15 dB elevation in the 3-6 kHz region. The presence and absence of notches correlated with the subjects' history of noise exposure. The 15 year pattern of change in age-adjusted pure-tone thresholds varied significantly by notch category. There was less change over time in the notch frequencies (3-6 kHz) and significantly greater change in the adjacent frequency of 2 kHz in the N2 group as compared to the NO and N1 groups. The adjacent frequency of 8 kHz showed a significant, but smaller, change in the N1 group as compared to the NO and N2 groups. The change at 2 kHz was independent of the starting hearing level at E15, whereas the changes at 4-8 kHz were influenced by the hearing level at E15. These data suggest that the noise-damaged ear does not 'age' at the same rate as the non-noise damaged ear. The finding of increased loss at 2 kHz suggests that the effects of noise damage may continue long after the noise exposure has stopped. The mechanism for this finding is unknown but presumably results from prior noise-induced damage to the cochlea. (C) 2000 Elsevier Science B.V. All rights reserved.