关键词: 睡眠呼吸暂停, 阻塞性, 听觉, 纯音听阈测定, 畸变产物耳声发射, 三酰甘油

Abstract: Background　Obstructive sleep apnea-hypopnea syndrome（OSAHS）-related pathological changes can lead to dysfunction of the inner ear and auditory system.However，it is not clear whether hyperlipidemia plays a role in this process.Objective　To investigate the correlations of auditory function with OSAHS severity and plasma triacylglycerol（TG）and the possible causes in moderate to severe OSAHS patients.Methods　50 inpatients with moderate to severe OSAHS（consisting of 25 normal and 25 elevated morning fasting plasma TG individuals）were recruited from Department of Otolaryngology，Ruijin Hospital，Shanghai Jiao Tong University School of Medicine from January 2017 to May 2019，and were compared with 20 healthy controls.Pure tone audiometry（PTA）and distortion-product otoacoustic emission（DPOAE）were measured in all participants and hearing threshold and signal-to-noise ratio（SNR）at different frequencies were recorded.Characteristics of auditory function and whether elevated TG was associated with the aggravation of hearing loss in OSAHS patients were analyzed.Pearson correlation analysis was used to explore the correlations of hearing threshold and SNR at different frequencies with characteristics of OSAHS patients.Results　Compared with the controls，OSAHS patients with normal TG had higher average hearing threshold of PTA at 2.00 kHz，4.00 kHz，and 8.00 kHz and overall average hearing threshold but lower average SNR of DPOAE at 4.00 kHz（P<0.05）.The mean SNR of DPOAE at 1.00 kHz，2.00 kHz and 8.00 kHz in OSAHS patients with elevated TG was lower than that of those with normal TG（P<0.05）.The hearing threshold of PTA at 0.50 kHz（r=0.227），1.00 kHz（r=0.362），2.00 kHz（r=0.328），4.00 kHz（r=0.403），and 8.00 kHz（r=0.463），and average hearing threshold（r=0.500）were positively correlated with age.The hearing threshold of 1.00 kHz（r=0.333），2.00 kHz（r=0.372），4.00 kHz（r=0.464），and 8.00 kHz（r=0.330），and average hearing threshold（r=0.399）were positively correlated with AHI.The hearing threshold of 2.00 kHz（r=-0.314）was negatively correlated with the lowest SaO2.The hearing threshold of 1.00 kHz（r=0.378），and 2.00 kHz（r=0.444）was positively correlated with TG.The SNR of DPOAE of 2.00 kHz（r=-0.221），4.00 kHz（r=-0.432）and 8.00 kHz（r=-0.441）was negatively correlated with age，meanwhile the SNR of 4.00 kHz（r=-0.545）and 8.00 kHz（r=-0.241）was negative correlated with AHI.The SNR of 1.00 kHz（r=-0.507）and 2.00 kHz（r=-0.385）was negatively correlated with TG（P<0.05）.Conclusion　Moderate to severe OSAHS patients have different degrees of hearing loss.Moreover，the hearing loss may be aggravated by elevated blood lipids.The severity of OSAHS increased with the aggravation of hearing loss.Moreover，increased age，AHI and TG were associated with aggravated hearing loss in OSAHS.

Key words: Sleep apnea, obstructive；Auditory perception；The pure tone threshold test；Deformed product otoacoustic emission；Triglyceride