主概念分析法用于失语症语料评估:基于常人对照的命名性失语语料研究  

Applying main concept analysis to discourse assessment in aphasia:research on anomic aphasia based on normal controls

作　　者：邓宝梅 林枫[1,3] 赖庆玲 陈珍珍 周亮[4] 江钟立[1,3] DENG Baomei;LIN Feng;LAI Qingling(The First Affiliated Hospital Nanjing Medical University,Nanjing,210029)

机构地区：[1]南京医科大学第一附属医院(江苏省人民医院),江苏南京210029 [2]中山大学附属第三医院康复医学科 [3]南京医科大学第三附属医院(南京医科大学附属逸夫医院) [4]浙江省人民医院

出　　处：《中国康复医学杂志》2021年第4期418-425,共8页Chinese Journal of Rehabilitation Medicine

基　　金：国家自然科学基金资助项目(81672255);江苏省科技支撑计划BE2012675;浙江省基础公益研究计划(LGF18H170005);江苏省高校哲学社会科学优秀创新团队建设项目资助(2017STD006)。

摘　　要：目的:探讨主概念分析法(MCA)在命名性失语语料分析中的有效性,并分析语料类型对该方法有效性的影响。方法:采集27例健康人和11例命名性失语患者在单图描述和组图叙事中的多媒体语料,根据健康人语料建立两种语料任务的主概念清单,对病例组和对照组进行主概念评分,比较两组的各主概念指标差异,分析语料类型对言语产出的影响,并探讨主概念分析法的评分者间信度和评分者内部信度。结果:在两种语料任务的主概念分析中,病例组的AC(准确且完整)、MC总分(主概念总分)均显著低于对照组(P<0.05),AI(准确且不完整)、AB(缺失)均显著高于对照组(P<0.05)。在单图描述的主概念分析中,病例组的IN(错误)显著高于对照组(P<0.05)。两种语料类型中,患者的MC总分均与失语商呈显著正相关。病例组和对照组在单图描述中的标准化AC、标准化MC总分均明显低于组图叙事(P<0.05)。主概念分析法在语料评估中有良好的评估者间信度和评估者内部信度。结论:主概念分析法可有效评价命名性失语的言语障碍,可为临床失语症的语料评估和分析提供新途径。Objective:To explore the effectiveness of main concept analysis(MCA)in the discourse analysis of patients with anomic aphasia and the influence of discourse types on it.Method:Multimedia discourse materials of 27 healthy subjects and 11 patients with anomic aphasia on the single picture description and sequential picture description were collected.The main concept checklists of two discourse tasks were established according to the corpus of healthy subjects.Main concept analysis was applied to score the spoken discourse productions by speakers with anomic aphasia and unimpaired individuals.Differences of main concept measurements between the two groups were compared to explore the validity and sensitivity of the MCA.Discourse productions on two discourse tasks were contrasted to investigate the influence of discourse types on spoken output.The inter-rater and intra-rater reliability of MCA were also evaluated.Result:In both single picture and sequential picture description,patients with anomic aphasia demonstrated significantly less AC main concepts and MC scores(P<0.05)as well as significantly more AI and AB main concepts(P<0.05)when compared to their matched healthy controls.IN main concepts were significantly lower in aphasic patients than the control group(P<0.05)in the single picture description.The MC scores of anomic patients were positively correlated with the aphasia quotient(AQ)in both two discourse tasks.The standardized AC and MC scores in both two groups were significantly lower in single picture description than sequential picture description(P<0.05).Good inter-rater and intra-rater reliability were observed when applied MCA in discourse evaluation.Conclusion:The main concept analysis is effective and appropriate to evaluate the discourse performances of patients with anomic aphasia in clinic,which provides a new approach for the assessment and analysis of discourse in aphasic patients.

关 键 词：主概念分析 语料评估 语料分析 语料类型 命名性失语 

分 类 号：R741[医药卫生—神经病学与精神病学]