左半球脑卒中后汉语语法缺失患者词法障碍的神经心理学意义

Neuropsychological significance of morphological deficits in patients with Chinese agrammatism after left-hemisphere stroke

目的:探讨左半球脑卒中后汉语语法缺失的词法障碍特点和可能存在的机制,为脑卒中后汉语语法缺失患者的语言康复提供理论依据。方法:选择武汉大学附属人民医院2002-01/09收治的急性左半球脑卒中后汉语语法缺失患者30例,排除完全失语和严重智能障碍者;以30例健康志愿者为正常对照组。应用《汉语失语检查法》和《汉语语法量表》中的词类测试任务(要求受试者复述80个句子,所用的词有名词、动词、形容词、复数词、量词、代词,介词、副词、连词、助词,复述正确,每句记1分,总分80分)对60例被试者进行测试,以评估脑卒中后汉语语法缺失患者的词法缺损程度。结果:60例被试者全部进入结果分析。①语法缺失组在词类测试l任务中总成绩低于正常对照组犤(82.69±16.04)%,(99.50±1.53)%,P<0.01犦。②其中语法缺失组在词类中的虚词、量词、复数“们”的测试成绩低于正常对照组犤(80.00±13.20)%,(79.83±13.55)%,(79.50±12.41)%;(93.50±9.40)%,(91.50±9.21)%,(91.33±9.64)%,P<0.01犦。③语法缺失组在名词、形容词、动词和代词的测试成绩与正常对照组无差异犤(96.50±4.58)%,(92.67±6.66)%,(95.17±6.23)%,(95.33±5.86)%;(96.67±4.61)%,(94.00±9.32)%,(97.00±4.28)%,(96.67±4.79)%,P>0.05犦。结论:汉语语法缺失患者对词类理解具有一定选择性地功能缺损,其机制可能与功能词类阶层破坏有关。

AIM： To investigate the characteristics and the mechanism of morphology deficits in patients with Chinese agrammatism after left-hemisphere stroke in order to provide the theoretical evidence for the rehabilitation of aphasia. METHODS： Thirty patients with Chinese agrammatism after lefthemisphere stroke hospitalized in Renmin Hosipital of Wuhan University between January 2002 and September 2002 were recruited.Patients with complete aphasia and severe mental disorder were excluded; and 30 healthy volunteers were set as normal control group. These thirty patients and 30 normal controls were examined by the standardized Aphasia Battery in Chinese （ABC） and the Chinese Agrammatism Battery （CAB） to evaluate the degree of morphology impairment of patients with Chinese agrammatism after left-hemisphere stroke. The testees were asked to repeat 80 sentences with noun, verb, adjective, plural word, measure word, pronoun, preposition, adverb, conj, auxiliary word, if they repeated correctly, 1 score was recorded for one sentence, totally 80 scores）. RESULTS：All the 60 testees entered result analysis.① The total score of the functional morpheme tasks in CAB was significantly lower in the patients group than that in the normal control group respectively [（82.69±16.04）%, （99.50±1.53）%, P 〈 0.01]. ② Total score of empty word, measure word and plural word in the patients group was lower than that in the normal control group respectivly [（80.00±13.20）% , （79.83±13.55）% , （79.50±12.41）% ; （93.50±9.40）%,（91.50±9.21）%, （91.33±9.64）%, P 〈 0.01].③There were no significant difference of the total scores of noun, adjective, verb and pronoun between patients group and normal control group [ （96.50±24.58）%, （92.67±6.66）%, （95.17±6.23）%, （95.33±5.86）% ; （96.67±4.61 ）%, （94.00±9.32）%, （97.00±4.28）%, （96.67±4.79）% ,P 〉 0.05]. CONCLUSION： Patients with Chinese agrammatism have selective impairment in functional morpheme, its mechanism might be related to hierarchical breakdown of functional categories.