脑卒中后吞咽障碍患者咀嚼效率的特征分析及其与健康受试者的比较

Mastication efficiency among stroke survivors with dysphagia

目的探讨年龄和性别对健康受试者咀嚼效率的影响;比较脑卒中后吞咽障碍患者与健康受试者咀嚼效率的差异以及与下颌运动临床评分的相关性。方法采用临床对照研究设计,选取健康受试者84例和脑卒中后吞咽障碍患者32例,所有受试者咀嚼双色口香糖,拍成高清图片后采用ViewGum软件分析图片,并记录口香糖的混合程度数据(SDHue值)。健康受试者分别按年龄(20~40岁组和≥65岁组)和性别进行分组,比较组间SDHue值有无差异;进一步将吞咽障碍患者的SDHue值与同年龄段健康受试者进行比较,并与下颌运动的临床功能评分进行相关性分析。结果健康受试者20~39岁组的SDHue值与≥65岁组比较,差异有统计学意义(P<0.05);健康受试者中,男性和女性的SDHue值差异没有统计学意义(P>0.05)。脑卒中后吞咽障碍患者的SDHue值明显高于健康受试者(P<0.05),且SDHue值与下颌运动的临床评分呈正相关(R2=0.35,P<0.05)。结论健康受试者的咀嚼效率不存在性别差异,但存在年龄差异;脑卒中后吞咽障碍患者的咀嚼效率(SDHue值)与脑卒中下颌运动临床评分呈正相关。

Objective To compare the effect of age and gender on mastication efficiency between healthy volunteers and dysphagic stroke survivors and to document any correlation of mastication efficiency with mandible movements.Methods Thirty-two stroke survivors with dysphagia and 84 healthy volunteers were asked to chew two-color gum.Their chewing efficiency was indicated by the degree of color mixing after chewing(SDHue).The SDHue value was evaluated using ViewGum software.The healthy volunteers were further divided into an age 20-40 years group,a 41-60 years group and an over-60 group.The SDHue values were compared among the 3 groups.The SDHue values were correlated with clinical mandibule movement scores.Results Among the healthy volunteers,those older than 60 years had significantly higher SDHue values on average than those between 20 and 40 years.However,no significant gender difference was observed.The dysphagic stroke survivors had,on average,significantly higher SDHue results than the healthy volunteers,and those results were positively correlated with their mandible movement scores.Conclusions Mastication efficiency tends to be age-related but not gender-related.Among those with post-stroke dysphagia mandible movement is positively correlated with mastication efficiency.