听力正常人群发生听觉过敏的影响因素及列线图预测模型构建

The influencing factors of hyperacusis in normal hearing population and the construction of a nomogram prediction model

程瑶;潘庆春;李蓓;王媛玲;张静;唐晓茗

1:川北医学院附属医院耳鼻咽喉头颈外科

摘要

目的探讨听力正常人群发生听觉过敏的影响因素并根据结果构建列线图预测模型，为早期识别听觉过敏高危人群制订预防策略提供科学依据。方法于2024年3月-2024年7月招募纯音听阈正常的自愿者410例，采用听觉过敏量表(hyperacusis questionnaire, HQ)对受试者进行听觉过敏评估，按照7∶3的比例将患者分为训练集(287例)及验证集(123例)。采用二元Logistic模型构建风险模型和列线图。分别采用受试者工作特征(receiver operating characteristic, ROC)曲线、校准曲线(Hosmer-Lemeshow)、临床决策曲线(clinical decision curve, DCA)和临床影响曲线对模型的区分度、准确度及临床适用性进行验证。结果 410例受试者中54例(13.17%,54/410)患者有听觉过敏，其中训练集38例(13.24%,38/287),验证集16例(13.01%,16/123)。套索回归及Logistic回归分析结果显示耳鸣(OR=3.784,95%CI:1.627～8.804)、焦虑(OR=3.860,95%CI:1.503～9.913)、抑郁(OR=3.118,95%CI:1.249～7.785)、偏头痛(OR=2.821,95%CI:1.147～6.937)、噪声接触史(OR=3.799,95%CI:1.715～8.416)是听力正常人群发生听觉过敏的影响因素。结论听力正常人群听觉过敏的发生率为13.17%,耳鸣、焦虑、抑郁、偏头痛、噪声接触史与听力正常人群听觉过敏的发生相关；基于以上因素构建的风险预测列线图模型有良好的区分度和校准度，可以较好地预测听力正常人群听觉过敏的发生风险，有一定的临床实用性。

关键词

听觉过敏;危险因素;列线图;听力

基金项目(Foundation):

南充市社会科学研究“十四五”规划2024年度项目(NC24B211、NC24C150);; 川北医学院临床医学院·附属医院2024年度科研发展计划(2024GC014)

作者

程瑶;潘庆春;李蓓;王媛玲;张静;唐晓茗

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