内收型痉挛性发声障碍患者的喉空气动力学特征分析

Analysis of Laryngeal Aerodynamic Parameters in Patients with Adductor Spasmodic Dysphonia

目的 分析内收型痉挛性发声障碍(adductor spasmodic dysphonia, ADSD)患者的喉空气动力学特征。方法 选取临床诊断为ADSD的患者18例为ADSD组,募集健康受试者30例为正常组。采用言语发声空气动力学测试系统(PAS)对受试者进行喉空气动力学评估,记录以下指标:声门下压(subglottal pressure, SGP)、发声阈压(phonation threshold pressure, PTP)、发声阈能(phonation threshold power, PTW)、声门阻力(glottal resistance, GR)及发声效率(vocal efficiency, VE)。对ADSD患者的嗓音进行主观听感知评估(consensus auditory perceptual evaluation of voice, CAPE-V),比较两组结果。结果 ADSD组的SGP、GR、VE、PTP大于正常组,差异有统计学意义(P<0.05);ADSD组的PTW与正常组间差异无统计学意义(P>0.05)。受试者工作特征曲线(receiver operating characteristic curve, ROC曲线)显示,SGP、GR及VE具有鉴别ADSD与正常组的价值(P<0.05)。ADSD患者嗓音听感知评估的总体严重程度与喉空气动力学指标均无明显相关性(P>0.05)。结论 喉空气动力学指标可有效评估ADSD,但与ADSD患者嗓音障碍的严重程度没有相关性。

Objective To investigate the characteristics of laryngeal aerodynamics in patients with adductor spasmodic dysphonia(ADSD). Methods Eighteen patients diagnosed with ADSD were enrolled in the ADSD group, and thirty healthy subjects were enrolled in the normal group. The laryngeal aerodynamic parameters of all the subjects were collected using the Speech Vocal Aerodynamics Test System(PAS), including subglottal pressure(SGP), phonation threshold pressure(PTP), phonation threshold power(phonation threshold power, PTW), glottal resistance(GR) and vocal efficiency(VE). Consensus auditory perceptual evaluation of voice(CAPE-V) was performed for ADSD patients. Results of the two groups were compared. Results SGP, GR, VE and PTP in ADSD patients were higher than those in normal group(P<0.05). There was no significant difference in PTW between ADSD group and normal group. The receiver operating characteristic curve(ROC curve) showed that SGP, GR and VE had the value of distingnishing between ADSD and normal group(P<0.05). There was no significant correlation between the laryngeal aerodynamic parameters and the voice perceptual evaluation severity in CAPE-V. Conclusion Laryngeal aerodynamic parameters could be used to evaluate ADSD, however, they were unrelated to voice perceptual evaluation severity in CAPE-V.