中重度皮层下失语的语言特征及训练疗效分析

Characteristics of Moderate and Severe Subcortex Aphasia and It's Language Training

目的筛查影响皮层下失语严重程度的因素,分析中重度皮层下失语患者语言障碍的特点及语言训练的疗效。方法选择皮层下失语症患者22例,其中中度10例,重度12例,于语言训练前后,分别采用汉语标准失语症检查法(CRRCAE)、波士顿失语症检查(BDAE)进行评估,筛查失语症严重程度的影响因素,分析语言障碍的特点及神经语言学特征,比较治疗前后各项语言能力差异。结果年龄、有无并发言语失用两个因素进入失语症严重程度的回归方程。皮层下失语症患者听理解、阅读理解、复述及出声读等语言能力相对保留。语言训练后,中度皮层下失语患者各项语言能力明显改善,重度皮层下失语患者听理解、复述、说、出声读、阅读等语言能力明显改善,书写能力改善不明显。结论年龄、是否并发言语失用可能是影响皮层下失语严重程度的重要因素。脑卒中后皮层下失语有特定的神经语言学特点,语言训练疗效显著,中重度皮层下失语患者语言训练疗效有差异。

Objective To screen the factors that affect severity of language disorder in subcortex aphasia,and analyze its characteristics and therapeutic effect.Methods 10 moderate degree and 12 severe degree subcortex aphasics were evaluated with Chinese Rehabilitation Research Center Aphasia Examination（CRRCAE） and the Boston Diagnostic Aphasia Examination（BDAE） before and 4 weeks after language training.The factors affecting severity of subcortex aphasia and characteristics were analyzed before training,and effect of language training was examined before and after training.Results Severity of subcortex aphasia was related to age and the complication of apraxia of speech.There was a relatively high level in listening comprehension,reading,repeating and reading aloud abilities.After training,all kinds of language abilities improved significantly in moderate degree subcortex aphasics.Whereas,comprehension and verbal communication capabilities increased obviously,but written communication abilities advanced rarely in severe degree subcortex aphasics.Conclusion Age and the complication of aphasia of speech may be important factors influencing severity of language disorder in subcortex aphasia.There are specific clinical features in subcortex aphasia.Almost all language abilities can be improved by language training,but therapeutic effect is differrent between moderate degree and severe degree subcortex aphasics.