Abstract: Background　Hearing loss is the most popular sensory organ disability in the world，and its negative impact ranks at the top of the global disease burden list.Therefore，prevention of deafness and hearing loss has become a public health project with common concern all over the world.Objective　To understand the main influencing factors of hearing loss among young people in Hangzhou.Methods　From June to September 2017，1 100 young people aged 18-28 from Hangzhou Hospital for the Prevention and Treatment of Occupational Disease were selected by convenient sampling method to conduct questionnaire survey and pure tone hearing test.The questionnaire included general demographic characteristics，family history of hearing loss，ear symptoms，use of mobile phones and earphones，frequency of access to entertainment places，attitude to hearing protection，and self-perceived hearing status.The pure tone hearing test used clinical audiological diagnostic criteria.The influencing factors of hearing loss were analyzed by χ2 test and multivariate Logistic regression analysis.Results　A total of 1 100 questionnaires were distributed，and 1 049 effective questionnaires were recovered with an effective recovery rate of 95.4%.And 71（6.8%） cases had low-frequency hearing loss in the left ear； 47（4.4%） cases had medium-frequency hearing loss；and 127（12.2%） cases had high-frequency hearing loss.And 40（3.8%） cases had low-frequency hearing loss in the right ear； 32（3.1%） cases had medium-frequency hearing loss，and 116（11.1%） cases had high-frequency hearing loss.There were statistically significant differences in hearing loss among young people in terms of gender，education level，tinnitus，earache，ear nausea，maximum volume of music release，ways of telephone answering，attitude towards hearing protection，and self-perceived hearing status（P<0.05）.The results of multivariate Logistic regression analysis showed that moderate volume〔OR（95%CI）=0.361（0.160，0.816）〕，low volume〔OR（95%CI）=0.418（0.219，0.797）〕，college and above degree〔OR（95%CI）=0.466（0.235，0.924） or 0.323（0.140，0.747）〕，female〔OR（95%CI）=0.478（0.277，0.827）〕，answering telephone with earphone〔OR（95%CI=0.448（0.236，0.852）〕 were the protective factors of hearing loss.The risk factors of hearing loss were poor self-perceived hearing status〔OR（95%CI）=2.050（1.067，3.940）〕，negative attitude towards hearing protection〔OR（95%CI）=3.350（1.782，6.300）〕，and earache〔OR（95%CI）=3.347（1.185，9.449）〕（P<0.05）.Conclusion　The prevalence of hearing loss among young people in Hangzhou is high.The music volume，education level，gender，ways of telephone answering，self-perceived hearing status，and attitude to hearing protection are the influencing factors of hearing loss.Comprehensive prevention and treatment should be conducted according to the influencing factors of hearing loss.

Key words: Young people, Hearing disorders, Hearing loss, Root cause analysis

摘要： 背景　听力损失是世界范围内广泛流行的感觉器官残疾，其负面影响居全球疾病负担排行榜的前列。因此预防聋和听力减退已成为世界各国共同关注的公共卫生项目。目的　了解年轻人听力损失的影响因素。方法　于2017年6—9月，采用方便抽样法抽取在杭州市职业病防治院健康体检的1 100例18~28岁年轻人作为研究对象。对其进行问卷调查和纯音听力测试，调查问卷内容包括一般人口学特征、听力损失家族史、耳部症状、手机和耳机使用状况、每月出入娱乐场所的频率、对待听力保护的态度、自我感觉听力状况等。纯音听力测试采用临床听力学诊断标准。听力损失影响因素采用χ2检验与多因素Logistic回归进行统计学分析。结果　共发放1 100份调查问卷，回收有效问卷1 049份，问卷有效回收率95.4%。左耳低频听力损失71例（6.8%），中频听力损失47例（4.4%），高频听力损失127例（12.2%）；右耳低频听力损失40例（3.8%），中频听力损失32例（3.1%），高频听力损失116例（11.1%）。不同性别、文化程度、耳鸣、耳痛、耳闷、音乐外放最大音量、接听电话方式、对待听力保护的态度、自我感觉听力状况年轻人听力损失情况比较，差异有统计学意义（P<0.05）。多因素Logistic回归分析结果显示，中等音量〔OR（95%CI）=0.361（0.160，0.816）〕、低音量〔OR（95%CI）=0.418（0.219，0.797）〕、大学及以上〔OR（95%CI）=0.466（0.235，0.924）或0.323（0.140，0.747）〕、女性〔OR（95%CI）=0.478（0.277，0.827）〕、用耳机接听电话〔OR（95%CI）=0.448（0.236，0.852）〕是听力损失的保护因素，自我感觉听力状况不好〔OR（95%CI）=2.050（1.067，3.940）〕、对待听力保护的态度消极〔OR（95%CI）=3.350（1.782，6.300）〕、耳痛〔OR（95%CI）=3.347（1.185，9.449）〕是听力损失的危险因素（P<0.05）。结论　杭州市年轻人听力损失患病率较高，音乐外放音量、学历、性别、接电话方式、自我感觉听力状况、对待听力保护的态度是听力损失的影响因素。应针对听力损失的影响因素进行综合防治。

关键词: 年轻人, 听力障碍, 听觉丧失, 影响因素分析