阿尔茨海默病患者自发言语的停顿特征  

The Pause Characteristics of Self Speaking in Alzheimer s Disease Patients

作　　者：李欣雨 于佳燕 肖永涛[1] Li Xinyu;Yu Jiayan;Xiao Yongtao(College of Medical Technology and Information Engineering,Zhejiang Chinese Medicine University,Hangzhou,310053,China)

机构地区：[1]浙江中医药大学医学技术与信息工程学院,杭州310053

出　　处：《听力学及言语疾病杂志》2024年第6期511-515,共5页Journal of Audiology and Speech Pathology

摘　　要：目的探讨轻中度阿尔茨海默病(Alzheimer s disease,AD)患者的自发言语停顿特征。方法选取简易智力状态检查(minimum mental state examination,MMSE)量表得分10~20分、且病程6个月~5年的轻中度AD患者20例作为AD组,年龄相匹配、认知功能正常受试者25例作为对照组。两组受试者分别进行自发言语表达,选取1 min连续音频,记录停顿总数,按停顿时长分为短时停顿(0.25 s≤t<0.50 s)、中时停顿(0.50 s≤t<0.90 s)、长时停顿(0.90 s≤t<2.00 s)和暂停(>2.00 s),计算各停顿类型均值,比较两组结果,对MMSE得分与停顿数量进行相关回归分析。结果AD组的短时停顿数量显著少于对照组(P<0.05),长时停顿、暂停的数量显著多于对照组(P<0.05);两组间中时停顿、总停顿的数量无统计学差异(P>0.05)。AD组内短时停顿的数量少于中时停顿和长时停顿(P<0.05);AD组中,中时停顿数量对MMSE得分有正向预测作用(β=0.515,P<0.05),暂停数量对MMSE有负向预测作用(β=-0.626,P<0.01)。结论轻中度AD患者在自发言语中产生时间较长停顿的频率更高,产生时间较短停顿的频率较低;认知水平较高的AD患者会产生更多时间较短的停顿,认知水平较低的AD患者会产生更多时间较长的停顿。Objective To study the characteristics of spontaneous speech pauses in individuals with mild to moderate Alzheimer s disease(AD).Methods A total of 20 patients with AD,exhibiting a Minimum Mental State Examination(MMSE)score ranging from 10 to 20 and a disease duration of 6 months to 5 years,were selected for the AD group.Twenty five cognitively normal and mentally healthy participants were chosen as the control group.Spontaneous speech was elicited from each participant,and 1-minute continuous audio recordings were used to tally pause counts categorized by duration into short pauses(0.25 s≤t<0.50 s),medium pauses(0.50 s≤t<0.90 s),long pauses(0.90 s≤t<2.00 s),and silences(>2.00 s).Mean values of each pause type were computed for inter-group and intra-group comparisons.Correlation and regression analyses between MMSE scores and pause counts were conducted within the AD group.Results Significant statistical differences were observed between the AD and control groups concerning the counts of short pauses,long pauses,and silences(P<0.05).Within the AD group,significant differences were found in the counts of short pauses versus medium pauses and short pauses versus long pauses(P<0.05).In the AD group,the count of medium pauses positively predicted MMSE scores(β=0.515,P<0.05),whereas the count of silences negatively predicted MMSE scores(β=-0.626,P<0.01).Conclusion Individuals with AD exhibit a higher frequency of longer duration pauses in spontaneous speech and a lower frequency of shorter duration pauses.Higher cognitive functioning in AD patients is associated with increased occurrences of shorter pauses,whereas lower cognitive functioning is linked to more extended pauses.

关 键 词：阿尔茨海默病 自发言语 停顿 

分 类 号：R749.1[医药卫生—神经病学与精神病学]