男声女调患者与正常男性嗓音参数的对比分析及临床意义

Contrastive analysis and clinical significance of voice parameters between patients with mutational falseto and normal males

目的探讨男声女调患者嗓音参数与正常男性嗓音参数的区别,为临床诊疗提供参考依据。方法收集30例男声女调及30例正常男性的动态喉镜及嗓音资料,对比分析其嗓音参数。结果 26例(86. 67%)男声女调患者动态喉镜下表现为声门闭合不全。男声女调患者发音时的基频(F_0)为(243. 3±42. 1) Hz,显著高于正常人的(146. 2±25. 4) Hz(P <0. 01);男声女调患者及正常人发音时的响度分别为(80. 0±8. 3) d BA、(82. 2±9. 1)d BA,两者经比较无统计学意义(P> 0. 05);男声女调患者发音时的振幅微扰(shimmer)为(2. 6±1. 4)%,与正常人的(1. 9±0. 7)%比较无统计学意义(P> 0. 05);男声女调患者及正常人发音时的基频微扰(jitter)均值分别为(0. 5±0. 2)%、(0. 6±0. 2)%,两者经比较无统计学意义(P> 0. 05);男声女调患者的嗓音障碍指数(voice handicap index,VHI)为-0. 5±1. 6,显著低于正常人的3. 8±1. 6 (P <0. 01);男声女调患者的最长发音时间(maxmum phonation time,MPT)为(16. 0±7. 5) s,较正常人的(32. 0±4. 9) s显著缩短(P <0. 01);音域(range)测量男声女调患者为(288. 4±140. 8) Hz,显著小于正常人的(611. 1±226. 1) Hz(P <0. 01)。结论大部分男声女调患者存在声门闭合不全。男声女调患者发音时的基频高于正常人,嗓音障碍指数低于正常人,最长发音时间较正常人缩短,音域较正常人变窄,而响度、振幅及基频微扰值与正常人相比无显著差异。

Objective To investigate the differences of voice parameters between patients with mutational falsetto and normal males. Methods 30 patients with mutational falseto（ patient group） and 30 normal males（ normal group）were included in this study. Their voice parameters were obtained with dynamic laryngoscopy and analyzed comparatively.Results Dynamic laryngoscopy showed incomplete glottic closure in 26（ 86. 67%,26/30） patients. The average fundamental frequency（ F0） of the patient group was（ 243. 3 ± 42. 1） Hz,which was much higher than that of the normal group [（ 146. 2 ± 25. 4） Hz]（ P 〈 0. 01）. The average pronunciation loudness of the patient group was（ 80. 0 ± 8. 3） d BA while that of the normal group was（ 82. 2 ± 9. 1） d BA,and the difference was statistically insignificant（ P 〉 0. 05）. Their differences of both shimmer [（ 2. 6 ± 1. 4） % vs（ 1. 9 ± 0. 7） %] and jitter [（ 0. 5 ± 0. 2） % vs（ 0. 6 ± 0. 2） %] were statistically insignificant（ both P 0. 05）. The voice handicap index（ VHI） in the patient group was-0. 5 ± 1. 6,which was significantly lower than that in the normal group（ 3. 8 ± 1. 6）（ P 〈 0. 01）. The maximum phonation time（ MPT） of the patient group was（ 16. 0 ± 7. 5） s,which was much shorter than that of the normal group（ 32. 0 ± 4. 9） s（ P 〈 0. 01）.The range in the patient group was（ 288. 4 ± 140. 8） Hz,which was much lower than that in the normal group [（ 611. 1 ±226. 1） Hz]（ P 〈 0. 01）. Conclusions Compared with normal males,most patients of mutational falsetto may have incomplete glottic closure with higher F0,lower VHI,shorter MPT and narrower range. However,their pronunciation loudness,shimmer and jitter are similar to normal.