应用汉语失语症心理语言评价探查失语症患者复述困难产生原因的研究

Identifing the source of repetition difficulties of aphasic patients by Psycholinguistic Assessment in Chinese Aphasia

目的:通过汉语失语症心理语言评价,探查失语症复述困难产生的原因。方法:采用汉语失语症心理语言评价的相关检查,对1例传导性失语症患者和1例混合性失语症患者进行语言功能评价。结果:病例1的听觉、视觉词图匹配测验结果基本正常,表明该患者语义系统未受到损害。声母、韵母、声调、单字听判断以及单字声调判断均在正常范围,表明该患者听觉通路的语音识别正常。非词复述、高表象词复述、看图复述均受损,看图单字复述(14/20)比非词单字复述(2/20)和高表象词复述(8/20)好(P<0.05),提示语义对该患者的复述有影响;看图单字复述(14/20)比三字复述(2/20)好(P<0.05),高表象词单字复述比三字复述要好(P<0.05),显示出词长效应。非词单字与高表象单字复述比较有显著差异(P<0.001),提示语音缓冲器内的语音表征不稳定。病例2听觉、视觉词图匹配受损,表明其语义系统受损。声母、韵母、声调听辨别均受损;非词复述中度受损,高表象词复述和看图复述轻度受损,看图复述未显示词长效应。结论:病例1传导性失语症的复述困难与语音缓冲器内的语音表征不稳定有关,病例2混合性失语症的复述困难与听觉语音识别受损有更大的关系。

Objective：To identify the sources of repetition difficulties of aphasic patients by Psycbolinguistic Assessment in Chinese Aphasia. Method： A conduction aphasic patient and a mixed aphasic patient were tested with Psyeholinguistic Assessment in Chinese Aphasia. Result： The case 1 with eondution aphasia showed normal auditory and reading word-picture matching, indicating his normal semantic system. The tests on consonant-pair, vowel-pair, intonation-pair, word-pair discrimination were normal, indicating his intact input phonological processing. His non-word repetition, high-image word repetition and word-repetition with seeing-picture were impaired. Single syllabe word-repetition was better than three syllables word-repetition, showing word length effect. Single syllable non-word repetition was much worse than single syllable word repetition, suggesting unstable phonological representations of verbal materials in the output buffer. The case 2 with mixed aphasia showed his auditory and reading word-picture matching were impaired, and consonant-pair, vowel-pair, intonation-pair, word-pair discrimination were impaired. Non-word and word- repetition were impaired, and did not show word length effect. Conclusion： The repetition difficulty of the conduction aphasia is caused by difficulty in maintaining stable phonological representations of verbal materials in the output buffer. The repetition difficulty of the mixed aphasia is greatly related with impaired phonological discrimination.