单侧声带麻痹患者嗓音主、客观评估及其相关性分析

Subjective and Objective Evaluation of Unilateral Vocal Cord Paralysis

目的以两种主观评估方法和嗓音声学分析法评估54例单侧声带麻痹患者的嗓音特征,并探索其相关性。方法对54例单侧声带麻痹患者和30例健康对照者分别进行嗓音声学分析以及简化嗓音障碍指数(VHI-10)和GRBAS主观评估,分析三种评估方法各指标间的相关性。结果嗓音声学分析显示,声带麻痹组的最大声时(maximum phonatory time,MPT)仅为对照组的1/3左右,基频微扰(jitter)、振幅微扰(shimmer)及标准化噪声能量(NNE)均较对照组为高,差异有统计学意义,二者间F0差异不明显。不同GRBAS分级中,VHI-10分值在1、2级间差异无统计学意义,但在1、3级间和2、3级间差异有统计学意义。在相关性方面,F0与其余各指标皆不相关;jitter、shimmer与除F0外的各主客观指标均相关;NNE除与jitter、shimmer相关外,与主观指标R和VHI-10的相关系数分别为0.347和0.331;MPT除与jitter、shimmer相关外,与主观指标的相关性均较高,与VHI-10和G的相关系数分别为-0.528和-0.466;GRBAS系统中,G与除F0、NNE外的各项指标均显著相关;R与除F0外的各项指标均显著相关;B与G类似,与除F0、NNE外的各项指标均有显著的相关性;VHI-10与除F0外的各指标均显著相关,但以MPT和G、R最显著。结论单侧声带麻痹患者的三种嗓音评估方法间有一定的相关性,全面的嗓音评估需采用综合的方法 。

Objective To explore the voice profiles of patients with unilateral vocal cord paralysis （UVCP） by two subjective and one objective methods, and to study the correlations of them. Methods A voice aeoustie analysis by Dr Speech was applied to 54 patients of unilateral vocal cord paralysis and 30 healthy control subjects, fundamental frequency（F0）, pitch perturbation（jitter）, amplitude perturbation （shimmer） and normalized noise energy （NNE）, as well as maximum phonatory time（MPT） as objective items to evaluate the differences between two groups. VHI-10 and GRBAS were applied on those patients as subjective evaluation, then the correlations of those three ways were evaluated. Results The two groups showed significant differences for F0, jitter, shimmer, NNE and MPT. All items except F0 had significant correlations. Conclusion There are significant correlations among VH1-10, （;RBAS and some voice acoustic analysis in UVCP, and a combined way was recommend toget compre hensive profiles of UVCP.