汉语纯失读症恢复过程中的神经语言学特点  

Neurolinguistic features during recovery of a Chinese patient with pure alexia

作　　者：陈晨[1] 刘晓加[1] 潘速跃[1] 吴小琴[1] 吴积宝[1] 

机构地区：[1]南方医科大学南方医院神经内科,广东广州510515

出　　处：《南方医科大学学报》2013年第5期713-718,共6页Journal of Southern Medical University

基　　金：国家自然科学基金(30370486)~~

摘　　要：目的对1例左顶枕部脑出血导致纯失读症的患者于急性期及恢复期分别进行语言能力检查并分析其神经语言学特点。方法采用汉语失语成套测试(ABC)、汉字阅读检查表(1999年,林谷辉)、汉语失写成套测验(CAB)对患者的阅读和书写能力进行检查。结果 (1)ABC检查发现该患者急性期口语表达和理解正常,语言障碍表现以阅读障碍为主,合并部分书写障碍;恢复期复查可见阅读障碍较书写障碍恢复更显著;(2)汉字阅读检查表检查结果为患者单字阅读的朗读、释义、配画能力基本平行。急性期单字阅读障碍以近形错误为主,兼有语义性错误、规则化发音错误及近音错误。恢复期复查仅出现近形错误;(3)CAB检查发现书写障碍由重到轻依次为看图书写、听写、主动书写,系列书写及抄写保留完好。恢复期看图书写和听写仍有损害,余书写项目为满分。书写障碍表现为失语性失写,均有明显的构字障碍和字词错写;主动书写过程为先有自发言语后有文字书写,写后能重新读出。结论汉语纯失读症患者语言各个成分的损害及恢复均不一致,推测语言各个成分均有其特有的神经心理学途径。Objective To analyze the neurolinguistic features of a Chinese patient with pure alexia in acute and convalescent stages. Methods We assessed the reading and writing abilities of the patient with the Aphasia Battery of Chinese （ABC）, the reading examination of Chinese characters （1999, Lin） and the Chinese agraphia battery （CAB）. Results In the ABC examination in the acute phase, the patient performed well in oral expression and comprehension, and the prominent linguistic abnormalities were alexia and merging agraphia; in the convalescent phase, the recovery of alexia was better than that of agraphia. In reading examination of Chinese characters, shape errors were the main reading disorders in the acute phase with a few semantic errors, regularization errors and mistakes in pronunciation, but only shape errors reappeared in the recovery period. CAB examination showed impairment of writing for pictures and dictation abilities in the recovery period but recovery of other writing abilities. The writing disorder was manifested as aphasic agraphia, with obvious dysorthography and lexical errors; the patient was capable of spontaneous writing only after spontaneous speech, and was able to read the written words. Conclusion The linguistic components of the Chinese patient with pure alexia showed different patterns of damage and recovery, suggesting the difference in their respective neuropsychological pathways.

关 键 词：失语症 纯失读症 失写症 神经心理学 功能恢复 

分 类 号：R743.3[医药卫生—神经病学与精神病学]