非流畅性失语患者口语产出障碍机制的研究  

Mechanism of Speech Production in Nonfluent Aphasia

作　　者：李文兵[1] 张通[2,3] 宋鲁平[2,3] 

机构地区：[1]武汉大学人民医院神经内科,湖北武汉市430060 [2]中国康复研究中心北京博爱医院神经康复科,北京市100068 [3]首都医科大学康复医学院,北京市100068

出　　处：《中国康复理论与实践》2012年第12期1101-1103,共3页Chinese Journal of Rehabilitation Theory and Practice

摘　　要：目的研究非流畅性失语患者口语产出障碍的机制。方法选用一系列熟悉成语,运用DMDX软件编制程序电脑屏幕呈现,分析在无语音提示下患者朗读具有唯一搭配形式的熟悉成语后面2个字的成绩(测验1)、在语音提示下朗读具有唯一搭配形式的熟悉成语后面2个字的成绩(测验2)和具有两种搭配形式的熟悉成语后面2个字的成绩(测验3),其中测验1与测验2所用成语完全一致,但呈现顺序是随机的。比较在三种条件下患者正确朗读成语后面2个字的正确数。结果患者完成3个测验的成绩分别为:测验1平均得分为(8.93±8.04)分;测验2平均得分为(13.63±6.26)分;测验3平均得分为(11.63±6.77)分。单因素三水平方差分析显示:主效应F(2,28)=10.125,P<0.001,三组测验之间得分具有非常高度显著性差异。测验1与测验2进行配对资料t检验,结果 t=3.511,P<0.01,提示对于同一组成语,给予语音提示后,被试成绩明显提高。测验1与测验3进行配对资料t检验,结果 t=2.526,P<0.05,提示虽两组所使用熟悉成语不同,但被试给予语音提示时的成绩好于无语音提示时的成绩。测验2与测验3进行配对资料t检验,结果 t=3.325,P<0.01,提示在均给予语音提示条件下,被试对只有一种搭配条件的成语朗读成绩明显好于具有两种搭配条件成语朗读的成绩。结论相关语音提示可提高非流畅性失语患者对熟悉成语的口语产出能力,非流畅性失语患者对语音编码的选择性提取能力出现障碍。Objective To explore the mechanism of speech production in nonfluent aphasia. Methods A series of very familiar idioms were presented to nonfluent aphasic patients using DMDX software on a computer screen under 3 different conditions. Group 1 was asked to read the last 2 words of each idiom without voice prompt. Group 2 was asked to read the last 2 words of each idiom with voice prompt. Group 3 was asked to read the last 2 words with voice prompt under the condition of 2 matching forms. The idioms in group 1 and group 2 were entirely same but the sequences were random. The number of errors was compared. Results The scores of 3 groups were （8.93~8.04）, （13.63~6.26）, and （11.63~6.77） respectively. That the 3 levels of single factor analysis of variance showed： main effect F^2.28~=10.125, P〈 0.001 showed that there was a statistically significant difference between 3 groups. That paired t-test between Group 1 and Group 2 was t= 3.511, P〈0.01 suggested that the scores improved with voice prompt. That paired t-test between Group 1 and Group 3 was t=-2.526, P〈0.05 suggested that the scores significantly improved with voice prompt. That paired t-test between Group 2 and Group 3 was t=-3.325, P〈0.01 suggested that Group 2 was better than Group 3 under the condition of voice prompt. Conclusion Voice prompt can improve nonfluent apha- sic patients on spoken output capacity for familiar idioms, and the patients may accompany disorder in speech coding for the selective ex- traction.

关 键 词：非流畅性失语 成语 言语产出 

分 类 号：R743[医药卫生—神经病学与精神病学]