左半球脑卒中后汉语语法缺失患者功能词的理解障碍

Disturbance of understanding of functional morpheme 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功能词理解障碍和可能存在的机制,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》中的语言符合操作任务[功能词与实质词操作(各20个)、以动词为中心和以名词为中心的句子组配各20组,要求患者将词卡上的词按检查者所读的句子排列组合成一完整句子,每句1分,总分60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功能词的理解障碍程度。结果:60例被试者全部进入结果分析。在语言符号操作测试中,语法缺失组总成绩低于正常对照组[(73.13±16.23)%,(94.50±4.13)%,P<0.01];语法缺失组组功能词的测试成绩低于正常对照组[(73.97±14.67)%,(86.43±11.47)%,P<0.01]。语法缺失组实质词测试成绩与正常对照组比无差异[(88.73±7.30)%,(90.40±7.98)%,P>0.05]。结论:汉语语法缺失患者对功能词的理解存在障碍,其机制可能与脑卒中后部分脑功能区障碍致功能词的异常加工有关。

AIM： To investigate the disturbance of understanding of functional morpheme in patients with Chinese agrammatism after left-hemisphere stroke and the possible existed mechanism, and to provide the theoretical evidence for the rehabilitation of aphasia. METHODS： Thirty patients with acute Chinese agrammatism after lefthemisphere stroke were selected from the Affiliated Renmin Hosipital of Wuhan University from January to September 2002. Those with complete aphasia and severe intelligent disorder were excluded. Thirty healthy volunteers were chosen as control group. Sixty testees were examined with the standardized Aphasia Battery in Chinese （ABC） and the Chinese Agrammatism Battery （CAB） [functional morpheme and substantive operation （every 20）, taking noun as center and the paired sentences taking noun as center every 20 groups, requiring the patients to arrange the a whole sentence according to the sentence read by the examiner, 1 point a sentence, totally 60 points] to evaluate the degree of disturbance of understanding of the functional morpheme in patients with Chinese agrammatism after stroke. RESULTS：Totally 60 testees were involved in the result analysis. In the operative test of linguistic symbol, the total score in the agranunatism group was lower than that in the normal control group [（73.13±16.23）%, （94.50±4.13）%, P 〈 0.01]. The score of functional morpheme in the agrammatism group was lower than that in the normal control group [（73.97±14.67）%, （86.43±11.47）%, P 〈 0.01]. The score of substantive test in the agrammatism group had no difference with the normal control group [（88.73±7.30）%,（90.40±7.98）%, P 〉 0.05]. CONCLUSION： The patients with Chinese agrammatism have obstacle in the understanding of functional morpheme, and its mechanism may has relation with the abnormal processing of functional morpheme in part of brain function region induced by the obstacle after stroke.