重症肌无力患者发声功能的检测

目的:研究重症肌无力患者发声功能的改变以及计算机嗓音分析系统在重症肌无力患者的诊断及疗效评价中的作用。方法:83例重症肌无力患者分为Ⅰ型(眼肌型)和Ⅱ型(全身型)2组,每组又按性别分为男、女2组;选择40例年龄、性别与其相匹配的健康成年人作对照组。分别在新斯的明试验前、后及常规治疗结束后行计算机声学检测,声学测试参数包括基频(F0)、频率微扰(jitter)、振幅微扰(shimmer)和标准声门噪声能量(NNE)。统计学方法采用独立样本资料t检验和配对资料t检验。结果:重症肌无力Ⅱ型组中,男、女2组的NNE值均高于对照组,差异有统计学意义(均P<0.05);F0值男性组和女性组分别与对照组比较,差异均有统计学意义(分别P<0.01和P<0.05)。新斯的明试验后及常规治疗后,F0和NNE值均降低,与试验前比较,差异均有统计学意义(均P<0.01)。结论:Ⅱ型重症肌无力患者发声功能异常,发声参数发生改变,表现为F0和NNE值升高,并随着病情的好转而下降。计算机声学测试对Ⅱ型重症肌无力患者的临床诊断和疗效观察具有一定的辅助参考价值。

The study of phonatory function in myasthenia gravis patients

OBJECTIVE: To investigate the phonatory function in myasthenia gravis patients and the role of acoustic analysis technique in the diagnosis and the assessment of therapeutic effect on treatment of myasthenia gravis. METHOD: Eighty-three myasthenia gravis patients diagnosed definitely in neurology were divided into two groups, ocular group and generalized group. Each group included male group and female group. Acoustic measures were carried out before and after neostigmine test and treatment. Forty healthy subjects including twenty male and twenty female served as control groups. The basic parameters of the voice using computed voice analysis included F0, shimmer, jitter and NNE. Independent-Samples T Test and Paired-Samples T Test were used. RESULT: The value of F0 and NNE increased in generalized group. The changes of F0 and NNE in generalized group were found to be statistically significant (P < 0.01, 0.05). Neostigmine resulted in an improvement in the parameters of F0 and NNE, the same condition happened after the treatment (P < 0.01). CONCLUSION: Phonatory function of generalized myasthenia gravis patients is abnormal. F0 and NNE increase in generalized myasthenia gravis patients and decrease after the treatment or the intake of neostigmine. Acoustic analysis is a useful method in the diagnosis and assessment of generalized myasthenia gravis patients.