摘要
目的分析环杓关节脱位(arytenoid dislocation,AD)患者嗓音障碍与计算机嗓音声学评估的相关性。方法选取2019年3月至2023年3月于南昌大学第二附属医院就诊的100例AD患者作为观察组,另选取同期本院体检中心100名嗓音正常的健康体检者作为健康组。采用发声障碍指数量表(voice handicap index-10,VHI-10)评估受检者嗓音功能,采用Multidimensional Voice Program Model 5105系统采集声带参数。比较观察组与健康组声带参数、VHI-10评分;根据观察组患者有无嗓音障碍分为有嗓音障碍组(n=80)与无嗓音障碍组(n=20),比较两组声带参数、VHI-10评分;根据观察组患者声音嘶哑程度分为轻度声音嘶哑组(n=10)、中度声音嘶哑组(n=39)、重度声音嘶哑组(n=51),比较3组声带参数、VHI-10评分。采用Pearson分析声带参数与VHI-10评分的相关性。绘制受试者工作特征(receiver operating characteristic,ROC)曲线,分析声带参数、VHI-10评分对嗓音障碍的预测价值。结果观察组噪谐比(noise-to-harmonic ratio,NHR)、嗓音基频(fundamental frequency,F_(0))、振幅微扰(Shimmer)、其频微扰(Jitter)、VHI-10评分均高于健康组,差异有统计学意义(P<0.05)。有嗓音障碍组NHR、F_(0)、Shimmer、Jitter、VHI-10评分均高于无嗓音障碍组,差异有统计学意义(P<0.05)。不同程度声音嘶哑组NHR、F_(0)、Shimmer、Jitter、VHI-10评分比较差异有统计学意义(P<0.05),且上述指标随着声音嘶哑严重程度的加重而依次升高,差异均有统计学意义(P<0.05)。NHR、F_(0)、Shimmer、Jitter与VHI-10评分均呈正相关(r>0,P<0.05)。NHR、F_(0)、Shimmer、Jitter、VHI-10评分联合预测嗓音障碍的曲线下面积最大为0.913,95%CI(0.789~0.946),灵敏度(94.28%)、特异度(90.08%)最高。结论AD患者声带参数NHR、F_(0)、Shimmer、Jitter与嗓音障碍VHI-10评分存在一定的相关性,联合检测可提高对嗓音障碍的预测价值,具有一定的临床参考价值。
Objective To analyze the correlation between voice disorder and computerized voice acoustic evaluation in patients with arytenoid dislocation(AD).Methods A total of 100 AD patients treated in the Second Affiliated Hospital of Nanchang University from March 2019 to March 2023 were selected as the observation group,and another 100 healthy patients with normal voice in the physical examination center of our hospital during the same period were selected as the healthy group.The voice function of the subjects was evaluated using the voice handicap index 10(VHI-10),and the vocal cord parameters were collected using the Model 5105 system of the Multidimensional Voice Program.Vocal cord parameters and VHI-10 scores were compared between the observation group and the healthy group.The patients in the observation group were divided into the voice disorder group(n=80)and the without voice disorder group(n=20),and the vocal cord parameters and VHI-10 scores were compared between the two groups.Patients in the observation group were divided into the mild hoarseness group(n=10),moderate hoarseness group(n=39)and severe hoarseness group(n=51)according to the degree of hoarseness,vocal cord parameters and VHI-10 scores were compared among the three groups.The correlation between vocal cord parameters and VHI-10 score was analyzed by Pearson.The receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of vocal cord parameters and VHI-10 score for voice disorder.Results The noise-to-harmonic ratio(NHR),fundamental frequency(F_(0)),amplitude perturbation(Shimmer),fundamental frequency perturbation(Jitter)and VHI-10 scores in the observation group were higher than those in the healthy group,and the differences were statistically significant(P<0.05).The NHR,F_(0),Shimmer,Jitter and VHI-10 scores in the voice disorder group were higher than those in the without voice disorder group,and the differences were statistically significant(P<0.05).There were statistically significant differences in NHR,F_(0),Shimmer,Jitter and VHI-10 scores among the among different degrees of hoarseness groups(P<0.05),and the above indexes increased with the aggravation of hoarse severity,the difference was statistically significant(P<0.05).NHR,F_(0),Shimmer,Jitter were positively correlated with VHI-10 scores(r>0,P<0.05).The area under the cure of NHR,F_(0),Shimmer,Jitter and VHI-10 scores combined for predicting voice disorders was the largest of 0.913,with a 95%CI(0.789~0.946),the sensitivity(94.28%)and specificity(90.08%)were the highest.Conclusion Vocal cord parameters NHR,F_(0),Shimmer,Jitter and VHI-10 score of AD patients are correlated to a certain extent,combined detection can improve the predictive value of voice disorders,which has certain clinical reference value.
作者
张智霖
叶孝灵
丁小美
ZHANG Zhilin;YE Xiaoling;DING Xiaomei(Department of Otolaryngology,Head and Neck Surgery,The Second Affiliated Hospital of Nanchang University,Nanchang,Jiangxi,330006,China)
出处
《当代医学》
2025年第4期40-44,共5页
Contemporary Medicine
关键词
环杓关节脱位
嗓音障碍
计算机嗓音声学
相关性
Arytenoid dislocation
Voice disturbance
Computer voice acoustics
Correlation
