摘要
目的探讨嗓音障碍疾病GRBAS听主观评估特征。方法对1 780例嗓音障碍患者行GRBAS评估,包括:听主观总嘶哑度G、粗糙度R、气息度B、无力度A、紧张度S分级评估,根据疾病种类进行统计分析。结果声带接触性肉芽肿、慢性单纯性喉炎、声带角化、声带小结、痉挛性发声障碍G、R评估以轻度异常为主,B评估多为正常和轻度异常,除痉挛性发声障碍S评估异常者达85%外,余几种嗓音障碍疾病A、S评估异常者少见;声带息肉、声带囊肿、声带任克水肿G、R、B评估以轻、中度异常为主,A、S评估异常者少见;声带良性肿瘤、声门癌、病理性声带沟、单侧声带麻痹、功能性发声障碍G、B评估以重度异常为主,声带良性肿瘤、声门癌R评估以重度为主,病理性声带沟、单侧声带麻痹R评估中度异常为主,而功能性发声障碍各级比例相近,这几种疾病的嗓音A评估虽然仍以正常者居多,但异常者明显增加,达23%～47%,S评估除功能性发声障碍异常者多达50%,余未见异常。所有嗓音障碍疾病中,声带接触性肉芽肿在G、R、A、S评估中最轻,痉挛性发声障碍在B评估中最轻,声门癌在G、R评估中最重,单侧声带麻痹在B、A评估中最重,痉挛性发声障碍在S评估中最重。从R、B、A、S与G的相关性看,痉挛性发声障碍S与G显著相关(r=0.717),其他各嗓音疾病均为R、B与G显著相关(r=0.582～0.965),其中,声带接触性肉芽肿、慢性单纯性喉炎、声带角化、声带小结、声带息肉、声带囊肿、声带任克水肿、声带良性肿瘤、声门癌为R与G相关性最高(r=0.885～0.965),病理性声带沟、单侧声带麻痹、功能性发声障碍则B与G相关性最高(r=0.746～0.833)。结论GRBAS听主观评估嗓音障碍不仅可显示嗓音障碍的程度,而且可间接反映发声时声带的基本特征,不同嗓音疾病具有不同特点,与声带病变的病理生理改变具有一致性。
Objective To investigate the subjective auditory --assessment characteristics of the scale of overall grade（G）, roughness（R）, breathiness（B）, asthenia（A）, strain（S） in voice disorders. Methods 1 780 dysphonia patients were assessed using the GRBAS scale, and the results were statistically analyzed. Results For the patients with vocal fold granuloma, chronic simple laryngitis, vocal fold keratosis, vocal nodule, and spasmodic dysphonia, the scales of G and R were most slightly abnormal and the scales of B were most normal and slightly abnormal. The abnormal scale of S of spasmodic dysphonia was 85%, the scales of A and S of the left groups were seldom abnormal. The outcomes of all measures against different disorders were identified and explained. The corrections among those factors and scales were analyzed and statistically processed. Conclusion Voicing disorders with the assessment GRBAS can not only evaluate the degrees of the disorders, but also indirectly assess the fundamental characteristics of vocal folds when speaking. Different voicing disorders have different characteristics, the outcomes of the experiment were consistent with the pathological and biological changes of diseases associated with vocal fold.
出处
《听力学及言语疾病杂志》
CAS
CSCD
北大核心
2009年第2期147-151,共5页
Journal of Audiology and Speech Pathology
关键词
嗓音疾病
听主观评估
Voice disorders
Subjective auditory assessment
作者简介
李红艳，女，北京人，主治医师，主要从事嗓音言语医学研究。现在首都医科大学附属北京天坛医院耳鼻咽喉科（北京100050）
通讯作者：徐文（Email：entwen@trhos．com）
