空气动力学参数在嗓音功能评估中的意义  

Role of aerodynamic parameters in voice function assessment

作　　者：郭永清[1] 林生智[2] 徐新林[2] 周莉[1] 庄佩耘[1] 蒋家琪[3] 

机构地区：[1]厦门大学附属中山医院耳鼻咽喉科,厦门361004 [2]福建医科大学协和临床医学院 [3]复旦大学附属眼耳鼻喉科医院耳鼻咽喉科

出　　处：《中华耳鼻咽喉头颈外科杂志》2012年第10期858-861,共4页Chinese Journal of Otorhinolaryngology Head and Neck Surgery

基　　金：国家自然科学基金项目（NSFC81070773）;国家自然科学基金海外及港澳学者合作研究基金（81028004）

摘　　要：目的 探讨空气动力学参数在嗓音功能评估中的应用及意义。方法采用言语发声空气动力学测试系统对正常嗓音、声带息肉、声带囊肿和声带运动障碍患者进行空气动力学参数采集并统计分析。结果100例正常嗓音组的发声阈气流（phonation threshold flow，PTF）、平均气流率（meadflowrate，MFR）、最长发声时间（maximum phonation time，MPT）和声门阻力（glottal resistance，GR）等气流相关参数的性别差异有统计学意义（P值均〈0．05），而发声阈压（phonation threshold pressure，PTP）、声门下压（subglottal pressure，SGP）和发音效率（vocal efficiency，VE）等压力相关参数性别差异无统计学意义（P值均〉0．05）。113例嗓音疾病患者除了GR和VE外，其他参数与正常对照组差异均有统计学意义（P值均〈0．05），而在嗓音疾病组间差异无统计学意义（P值均〉0．05）。ROC曲线分析显示除GR外的其他参数均有临床诊断价值，以PTP的诊断价值最大。嗓音障碍程度不同的声带息肉患者空气动力学参数差异均无统计学意义（P值均〉0．05），而41例声带息肉术后患者除了GR和VE外的其他参数均较术前变化，差异有统计学意义（P值均〈0．05）。结论空气动力学参数能客观有效评估嗓音功能变化，具有良好的辅助诊断价值。Objective To investigate the application and significance of aerodynamic parameters in voice function assessment. Methods The phonatory aerodynamic system （PAS） was used to collect aerodynamic parameters from subjects with normal voice, vocal fold polyp, vocal fold cyst, and vocal fold immobility. Multivariate statistical analysis was used to compare measurements across groups. Results Phonation threshold flow （PTF） , mean flow rate （MFR） , maximum phonation time （MPT） , and glottal resistance （ GR ） in one hundred normal subjects were significantly affected by sex （ P 〈 0. 05 ）, while phonation threshold pressure （PTP） , subglottal pressure （SGP） , and vocal efficiency （VE） were not （ P 〉 0. 05 ）. PTP, PTF, MFR, SGP, and MPT were significantly different between normal voice and voice disorders （P 〈 0. 01 ） , and there were no significant differences among the three disorders （ P 〉 0. 05 ）. Receiver operating characteristic （ROC） analysis found that PTP, PTF, SGP, MFR, MPT, and VE in one hundred thirteen voice dis orders had similar diagnostic utility （P 〈 0. 01 ）, with PTP exhibiting the highest area under the curve. The aerodynamic parameters of the three degrees of voice dysfunction due to vocal cord polyps were compared and found to have no significant differences（P 〉0. 05）. PTP, PTF, MFR, SGP and MPT in forty one patients with vocal polyps were significantly different after surgical resection of vocal cord polyps （P 〈 0. 01 ）. Conclusion The aerodynamic parameters can objectively and effectively evaluate the variations of vocal function, and have good auxiliary diagnostic value.

关 键 词：语音障碍 语音质量 气压 

分 类 号：R767.92[医药卫生—耳鼻咽喉科]