嗓音障碍性疾病患者应用VHI评估与嗓音声学分析的比较

CORRELATION BETWEEN VHI AND VOICE ACOUSTIC ANALYSIS IN DYSPHONIC PATIENTS

目的探讨嗓音障碍指数(voice handicap index,VHI)用于嗓音障碍性疾病患者自我评估的临床意义及与声学参数间的相关性。方法对嗓音障碍性患者114例(患者组)及嗓音正常者40例(对照组)采用多维嗓音软件(multi dimensional voice program,MDVP)进行嗓音声学分析和VHI调查,嗓音声学分析指标包括基频、基频微扰、振幅微扰、噪声/谐和比(noise to harmonic ratio,NHR),VHI调查包括功能(function,F)、生理(physiology,P)、情感(emotion,E)3个范畴,记录3方面得分及总分(total scores of the VHI,TVH)分值。结果患者组的基频微扰、振幅微扰、NHR均高于正常组,差异有统计学意义(P<0.01);患者组与对照组间VHI差异有统计学意义(P<0.01)。VHI中P与E之间(r=0.863),F与TVH之间(r=0.818)、P与TVH之间(r=0.929)、E与TVH之间(r=0.910)均有良好相关性(P<0.01);VHI各范畴与嗓音各参数之间无显著相关性(P>0.05)。结论临床上不能以嗓音声学分析为标准来预测主观评估结果;VHI可用于主观反映患者的嗓音障碍程度。

Objective To analyse the relationship between voice acoustic analysis （VAA） and voice handicap index （ VHI ） in dysphonic patients, and to investigate the characteristic of the VHI. Methods One hundred and fourteen dysphonic patients（ dysphonia group） and 40 subjects with normal voice （control group ） were tested by multi dimensional voice program （MDVP）and underwent VHI. Fundamental frequency,pitch perturbation,amplitude perturbation（shimmer） and rLoise to harmonic ratio （NHR） as objective items of the voice acoustic analysis were evaluated. Voice handicap index （VHI） concluded function（F） , physiology （P） and emotion （E）, and the the total scores of the VHI were recorded. Results The parameters such as jitter,shimmer,NHR in dysphonia patients were much higher and Fo was lower than those in the normal voice group. The average score of VHI had obvious significant difference between the two groups. There were well correlations between P and E （ r = 0. 863 ） , Fand TVH （r =0.818）, P and TVH （r =0.929） ,E and TVH （r =0. 910） （P 〈0.01）. There was no correlation between VHI and VAA （P 〉 0.05）. Conclusion VAA can not be used as a standard to speculate the subjective evaluation of dysphonia,while VHI can reflect the level of dysphonia in dysphonic patients.