嗓音声学检测对喉白斑患者嗓音评估的临床价值

Clinic Value of the Vocal Acoustics on Voice Evaluation in Patients with Larynx Leukoplakia

目的探讨嗓音声学检测对喉白斑患者嗓音评估的临床价值。方法采用Dr.Speech软件对48例喉白斑患者(喉白斑组)和50例健康者(正常组)进行嗓音分析和电声门图(EGG)检测,比较2组基频微扰(Jitter)、振幅微扰(Shimmer)、噪声能量(NNE)、谐噪比(HNR)、信噪比(SNR)、最长发声时间(MPT)6个嗓音分析参数和EGG-Jit-ter、EGG-Shimmer、EGG-NNE、EGG-HNR、EGG-SNR、接触率微扰(CQP)、接触幂微扰(CIP)7个EGG参数,并分析EGG波形。结果嗓音分析参数中,喉白斑组Jitter、Shimmer和NNE均高于正常组,HNR、SNR和MPT均低于正常组(均P<0.05);EGG参数中,喉白斑组EGG-Jitter、EGG-Shimmer、EGG-NNE、CQP和CIP均高于正常组,EGG-HNR、EGG-SNR均低于正常组(均P<0.05)。喉白斑组EGG波形渐开相速度加快,整个闭合相缩短,呈尖峰状,波形规律,波形异常率占72.9%(34/48)。结论嗓音分析和EGG同步化测试可为声嘶程度提供客观指标,为喉白斑的预防、疗效评估、术后复发和发音矫治提供嗓音学依据。

Objective To explore the clinic value of the vocal acoustics on voice evaluation in larynx leukoplakia pa-tients. Methods Dr. Speech software was used to perform voice acoustic analysis and deduce EGG parameters in 48 sub-jects with larynx leukoplakia and 50 normal subjects. Voice acoustic analysis parameters（Jitter, Shimmer, NNE, HNR,SNR, MPT）, EGG parameters（ EGG-Jitter、EGG-Shimmer、EGG-NNE、EGG-HNR、EGG-SNR, CQP,CIP） and EGG wave-form were compared between two groups. Results For voice acoustic analysis, Jitter, Shimmer, NNE in larynx leukoplakiagroup were higher than those in normal group while HNR, SNR in larynx leukoplakia group were lower than those of normalgroup. What＇s more,MPT in larynx leukoplakia group was obviously shorter than that in normal group with, statistically sig-nificant difference（P〈0.05）. For EGG analysis, EGG-Jitter, EGG-Shimmer, EGG-NNE were higher in larynx leukoplakiagroup than those in normal group with significant difference（P〈0.05）. EGG-HNR and EGG-SNR in larynx leukoplakiagroup were lower than those in normal group. Furthermore, CQP and CIP in larynx leukoplakia group were higher than thosenormal group with statistically significant difference（P〈0.05）. Most patients＇（72.9%） EGG waveform showed gradually ac-celerate phase velocity and fast close phase, which represent a spike-like shape. Conclusion Voice acoustic analysis com-bined with EGG provide objective indicators to assess degree of hoarseness, and to provide sonic evidences for prevention,recurrence, assessment and pronunciation correction of the larynx leukoplakia.