成年卒中后非流畅性失语症患者言语韵律功能特征  

Characteristics of speech prosody function in adults with non-fluent aphasia after stroke

作　　者：王哲 万勤[1,2] 黄昭鸣 王勇丽[1,2] 钱红 WANG Zhe;WAN Qin;HUANG Zhaoming;WANG Yongli;QIAN Hong(Department of Rehabilitation Science,Faculty of Education,East China Normal University,Shanghai 200062,China;Institute of Chinese Speech and Hearing Rehabilitation Science and ICF Application,East China Normal University,Shanghai 200062,China;Department of Rehabilitation Medicine,Shanghai Fifth Rehabilitation Hospital,Shanghai 201600,China)

机构地区：[1]华东师范大学教育学部康复科学系,上海市200062 [2]华东师范大学中国言语听觉康复科学与ICF应用研究院,上海市200062 [3]上海市第五康复医院康复医学科,上海市201600

出　　处：《中国康复理论与实践》2024年第8期979-992,共14页Chinese Journal of Rehabilitation Theory and Practice

基　　金：国家社会科学基金项目(No.20AZD125)。

摘　　要：目的探讨非流畅性失语症患者言语韵律组块、情感、焦点、交互韵律功能的特征。方法2023年12月至2024年3月,于上海市第五康复医院招募卒中后非流畅性失语症患者(试验组,n=25)和健康被试(对照组,n=25),采用改编的言语韵律功能评估工具和声学分析仪器比较两组组块、情感、焦点、交互功能表现的差异。结果组块韵律中,两组听分辨不同组块(Z=-4.856,P<0.001),听识别“2个组块”(Z=-3.024,P=0.002),模仿输出“2个组块”及自主输出“2个组块”和“3个组块”的主观得分、停顿总时长、平均停顿时长、平均音节时长和构音速率(|Z|>2.911,P<0.001)存在显著性差异。情感韵律中,两组听分辨不同情感(Z=-3.322,P=0.001),听识别“喜欢情感”(Z=-3.481,P=0.001),模仿输出“喜欢情感”的主观得分(Z=-6.214,P<0.001)、平均强度(Z=-3.581,P<0.001)、强度标准差(Z=-3.181,P=0.001),自主输出“喜欢情感”的主观得分(Z=-5.510,P<0.001)、平均强度(Z=-3.429,P=0.001)、强度标准差(Z=-4.777,P<0.001)、基频变化范围(t=1.852,P=0.029)存在差异。焦点韵律中,两组听分辨不同重音(Z=-2.658,P=0.008),听识别“句尾”重音(Z=-2.023,P=0.011),模仿输出“句首”重音的重音强度峰值(t=8.294,P<0.001),模仿输出“句中”“句尾”重音的主观得分(|Z|>5.102,P<0.001)、重音强度峰值(t>8.298,P<0.001),自主输出“句首”焦点的主观得分(Z=-4.371,P<0.001)和重音强度峰值(t=8.842,P<0.001),自主输出“句中”“句尾”焦点的主观得分(|Z|>4.970,P<0.001)、重音强度峰值(t>9.373,P<0.001)和重音持续时间(|t|>2.912,P<0.01)存在显著性差异。交互韵律中,两组听分辨和听识别均无显著差异(P>0.05),模仿复述及自主表达疑问语气的主观得分(|Z|>4.938,P<0.001)和基频斜率k(|t|>4.609,P<0.001)存在显著性差异。结论非流畅性失语症患者言语韵律输入和输出功能均下降,在“2个组块”“喜欢情感”“句尾焦点�Objective To explore the characteristics of speech prosody chunking,affect,focus and interaction function in patients with non-fluent aphasia after stroke.Methods From December,2023 to March,2024,patients with non-fluent aphasia after stroke(experimental group,n=25)and healthy subjects(control group,n=25)were recruited from Shanghai Fifth Rehabilitation Hospital,and the two groups were compared in terms of chunking,affect,focus and interaction performance using a self-administered speech prosody function assessment tool and acoustic analyzing instrument.Results In chunking prosody,there were differences in auditory discrimination(Z=-4.856,P<0.001),auditory recognition of"two chunks"(Z=-3.024,P=0.002),and subjective scores,total pause duration,average pause duration,average syllabic duration and structural sonic rate(|Z|>2.911,P<0.001)of imitating"two chunks"and autonomously outputing"two chunks"and"three chunks"between two groups.In affect prosody,there were differences in listening to distinguish different emotions(Z=-3.322,P=0.001),listening to identify"like emotion"(Z=-3.481,P=0.001),and the subjective score(Z=-6.214,P<0.001),average intensity(Z=-3.581,P<0.001)and standard deviation of intensity(Z=-3.181,P=0.001)of imitating"like emotion"between two groups;there were differences in the subjective score(Z=-5.510,P<0.001),average intensity(Z=-3.429,P=0.001),standard deviation of intensity(Z=-4.777,P<0.001)and fundamental frequency variation range(t=1.852,P=0.029)of autonomously outputing"like emotion"between two groups.In focus prosody,there were differences in listening to distinguish different focuses(Z=-2.658,P=0.008),listening to identify the"end of sentence"focus(Z=-2.023,P=0.011),and the peak stress intensity of imitating the"first sentence"focus(t=8.294,P<0.001);the subjective score(|Z|>5.102,P<0.001)and peak stress intensity(t>8.298,P<0.001)of imitating the"mid-sentence"and"end-sentence",and the subjective score(Z=-4.371,P<0.001)and peak stress intensity(t=8.842,P<0.001)of autonomously outputing the focu

关 键 词：脑卒中 非流畅性失语症 成年人 韵律功能 言语韵律 

分 类 号：R743.3[医药卫生—神经病学与精神病学]