3～5岁痉挛型脑瘫患儿构音清晰度研究

目的：研究痉挛型脑瘫患儿构音清晰度及其影响因素。方法以76例3～5岁痉挛型脑瘫患儿为研究对象，采用儿童词语理解能力测验评估患儿的语言理解能力，黄昭鸣-韩知娟词表测试患儿的构音清晰度，测量其汉语顶点元音/i/、/u/、/a/的第一共振峰（F1）和第二共振峰（F2），求得元音空间、舌距F2（i）-F2（u）和下颌距F1（a）-F1（i），检验患儿构音清晰度与年龄、舌距、下颌距、元音空间、词语理解能力得分之间的相关性。结果76例痉挛型脑瘫患儿整体构音清晰度分数平均为（66.8±29.3）%。37～47月龄组的整体构音清晰度低于48～59月龄组和60～71月龄组，差异有统计学意义。语言理解能力迟缓患儿的整体构音清晰度低于语言理解能力中等患儿，差异有统计学意义。不同性别脑瘫患儿整体构音清晰度差异没有统计学意义。76例痉挛型脑瘫患儿中有34例患儿存在构音障碍，构音障碍率为44.7%。语言理解能力迟缓患儿构音障碍率高于语言理解能力中等患儿，差异有极显著统计学意义（P=0.002）。不同年龄、性别的脑瘫患儿构音障碍率差异没有统计学意义。痉挛型脑瘫患儿整体构音清晰度与年龄、舌距、下颌距、元音空间、词语理解能力得分呈正相关，具有统计学意义。结论3～5岁痉挛型脑瘫患儿的构音清晰度随着年龄、舌距、下颌距、元音空间、词语理解能力得分的增加而提高，不受性别因素的影响。

The Articulation Clarity in Spastic Cerebral Palsy Patients of 3-5 Years

To study the clarity of articulation of patients with spastic cerebral palsy and its influential factors.Methods 76 patients with spastic cerebral palsy aged from 3 to 5 years old were recruited in this study. The Vocabulary Comprehension Test of Children （VCTC） was used to assess the language comprehension abilities of the children. The Huang zhoming-Han zhijuan Test was used to evaluate the clarity of articulation. The first formant （F1）and the second formant（F2）of the Chinese point vowels /i/、/u/、/a/ were measured to calculate the vowel space area, tongue space[F2（i）- F2（u）] and jaw space [F1（a）-F1（i）]. The correlations between clarity of articulation and age, tongue space, jaw space, vowel space area, vocabulary comprehension score were studied.Results The average score of the clarity of articulation in 76 children with spastic cerebral palsy was （66.8±29.3）%. The score of the clarity of articulation in 37-47 -month-old group was significantly lower than that in 48-59-month-old group and 60-71 -month-old group. The score of the clarity of articulation in patients with retarded language comprehension abilities was significantly lower than that in patients with average language comprehension abilities. There was no significant difference between male and female patients in the clarity of articulation. 34 of 76 children with spastic cerebral palsy had dysarthria, with an incidence of 44.7%. The prevalence of dysarthria in patients with retarded language comprehension abilities was significantly higher than that in patients with average language comprehension abilities. There was no significant difference in the prevalence of dysarthria among patients of different ages and genders. There were significant positive correlations between the clarity of articulation and age, tongue space, jaw space, vowel space area, vocabulary comprehension score.Conclusion The clarity of articulation in patients with spastic cerebral palsy improves with increasing age, tongue space, jaw space, vo