鼻咽癌放疗后构音障碍患者舌尖音的舌尖上抬幅度和速度研究

关键词：构音障碍  舌  鼻咽癌  电磁发音仪

Keywords:dysarthria  lingual  nasopharyngeal carcinoma  electromagnetic articulography

摘要：

      摘要 目的：分析鼻咽癌放疗后构音障碍患者舌尖音的舌尖上抬幅度和速度，探讨肌肉纤维化影响舌构音运动的机制。 方法：鼻咽癌放疗后构音障碍患者和正常对照受试者读出汉语构音障碍评估的单词检查表，利用麦克风和电磁发音仪（EMA）同步记录受试者的语音信号和舌尖运动数据。根据检查表中四个包含舌尖辅音词语的音频信号，截取发音前舌尖上抬的动作数据，计算得到舌尖运动的幅度和平均速度，采用重复性方差分析比较两组受试者间，以及不同辅音—元音组合间的舌运动特征。 结果：构音障碍患者组和对照组舌尖音的舌尖上抬幅度没有显著性差异；不送气舌尖音/d/后接舌位较高的复元音/ian/时，舌尖上抬的幅度大于舌位较低的复元音/ai/。患者组舌尖上抬的平均速度明显小于对照组；送气舌尖音/t/舌尖上抬的平均速度显著高于不送气音/d/；后续元音为/ian/时平均速度大于元音为/ai/时。 结论：鼻咽癌放疗后构音障碍患者舌的运动速度先于运动幅度受到肌肉纤维化的影响，送气与不送气舌尖音后续不同舌位元音时具有特异性的发音机制。

Abstract:

      Abstract Objective: To explore the lingual elevating amplitude and velocity of alveolar consonants produced by the dysarthric patients with nasopharyngeal carcinoma(NPC) following radiation therapy and illuminate the underlying mechanisms of lingual movement influenced by the muscle fibrosis. Method: The audio signal and the coordinates of lingual movement were recorded simultaneously by microphone and electromagnetic articulography(EMA) while the NPC patients of dysarthria and control subjects were reading the word list of Chinese dysarthria assessment. The coordinates of lingual movements while reading the words containing alveolar consonants were extracted according to the time window defined by the audio signal.The amplitudes and averaged velocities of apex linguae were calculated and repeated analysis of variance(RM-ANOVA) was conducted to compare the difference between subject groups and consonant-vowel combinations. Result: There was a lack of significant difference of lingual elevation amplitudes between patients and controls,however,the amplitude of voiceless consonant combined with vowel of high tongue place was greater than that of vowel of low tongue place. Significant main effects of groups, consonant and vowel categories were revealed by three way RM-ANOVAs performed on the velocity of lingual elevation. Slower movements were showed in the patient groups,with the voiceless consonants and the vowels with low tongue place,respectively. Conclusion: The velocity of lingual movement was influenced by the muscle fibrosis earlier than the amplitude. Specific kinetic mechanisms were adopted to improve the differentiation of varied combinations of consonant and vowel categories.