北京大学学报(医学版) ›› 2014, Vol. 46 ›› Issue (5): 751-755.

• 论著 • 上一篇    下一篇

21例伴构音障碍的肌萎缩侧索硬化症患者嗓音特征分析

谢华顺1 ,马芙蓉1△,樊东升2△,王丽平2,闫燕1,鹿培泉1   

  1. (北京大学第三医院1.耳鼻咽喉科, 2.神经内科,北京100191)
  • 出版日期:2014-10-18 发布日期:2014-10-18

Acoustic analysis for 21 patients with amyotrophic lateral sclerosis complaining of dysarthria

XIE Hua-shun1, MA Fu-rong1△, FAN Dong-sheng2△, WANG Li-ping2, YAN Yan1, LU Pei-quan1   

  1. (1.Department of OtolaryngologyHead & Neck Surgery, 2..Department of neurology, Peking University Third Hospital, Beijing 100191, China)
  • Online:2014-10-18 Published:2014-10-18

摘要: 目的:回顾性分析伴有构音障碍的21例肌萎缩侧索硬化症患者嗓音声学参数特征,探讨多维语音分析系统对此类患者构音障碍程度的评估可能性及其临床应用价值。 方法:收集21例伴有构音障碍诊断明确的肌萎缩侧索硬化症患者临床资料及语音清晰度测试结果,分析比较此21例肌萎缩侧索硬化症患者及44例正常人发持续稳态元音[a:]嗓音分析的资料。 结果:21例患者中,语音清晰度得分97%以上者10例,其中5例得分为100%。发现语音清晰度得分与病程、起病部位无相关性。言语损害明显组和言语损害轻微组噪谐比均高于正常对照组噪谐比,差异有统计学意义(P<0.05)。言语损害明显组频率微扰(jitter)与对照组比较,差异有统计学意义(P<0.05)。结论:多维语音分析系统可以评估伴有构音障碍的肌萎缩侧索硬化症患者嗓音异常。发持续稳态元音[a:]时,伴构音障碍的患者噪音成分大于正常人,噪谐比是用于评估患者嗓音异常较敏感、稳定的参数。伴有构音障碍的患者声音的基频不受影响,言语损害明显组异常参数较多。

关键词: 肌萎缩侧索硬化, 构音困难, 声学

Abstract: Objective:To observe the characteristics of acoustic parameters of 21 patients with amyotrophic lateral sclerosis (ALS) complaining of dysarthria and to explore the possibility and clinical value of Multi-Dimensional Voice Program (MDVP) on aseessing the patient’s voice. Methods: The clinical data and speech intelligibility of each of the 21 patients with ALS complaining of dysarthria were collected. All the 21 patients with ALS and 44 normal subjects were suggested to pronounce the vowel [a:].The voice samples were collected and analyzed by Multi Dimensional Voice Program. The data were compared to detect the difference between the two groups. Results: Speech intelligibility of 10 in the 21 patients was above 97% including 5 patients whose scores were 100%. It seemed that the speech intelligibility score was not related with the duration of the disease and the onset part. The values of noise to harmonic ratio (NHR) of both the light and the severe damage to the speech group were higher than those of the control group with significant difference (P<0.05).Significant difference was noticed between the severe damage to the speech group and control group in Jitter. Conclusion: Multi Dimensional Voice Program could be used to analyze the characteristics of acoustic parameters of patients with ALS patients complaining of dysarthria. There was more noise composition in the voice of the patients with dysarthria. NHR seemed to be the sensitive and stable parameter. Especially in patients whose speech intelligibility were affected severely, more acoustic parameters were detected with significant difference.

Key words: Amyotrophic lateral sclerosis, Dysarthria, Acoustic

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