命名性失语患者语篇表达能力及与命名和认知能力的相关性分析

关键词：命名性失语  语篇表达  命名能力  认知  相关性

Keywords:anomic aphasia  discourse production  naming ability  cognitive  correlation

摘要：

      摘要 目的：分析卒中后命名性失语患者在语篇任务中的话语表现，并探讨语篇表达能力与命名和认知能力之间的相关性。 方法：纳入命名性失语患者和健康人各29例。采集两组受试者在看图说话和故事讲述中的多媒体语料。统计语量、语速、平均句长和词汇多样性4项话语指标，比较命名性失语患者与健康人的语篇话语指标差异，并分析命名性失语患者话语指标与命名能力（包括物品命名、自发命名、完成句子和反应性命名）及与认知功能之间的相关性。 结果：失语组在看图说话和故事讲述中的语速、平均句长和词汇多样性均显著低于对照组；失语组的语量在看图说话中与对照组相当（P>0.05），而在故事讲述中显著低于对照组（P<0.05）。在看图说话和故事讲述中，失语组的语速与物品命名能力之间均呈显著正相关关系（P<0.05）。看图说话中的语量、语速和平均句长均与定向力及注意力和计算力呈显著正相关关系（P<0.05）。故事讲述中的语量与定向力、注意力和计算力、回忆能力和语言功能显著正相关（P<0.05），语速与定向力显著正相关（P<0.05），平均句长与回忆能力显著正相关（P<0.05）。 结论：命名性失语患者语篇表达能力较健康人明显下降。患者语篇表达的语速与物品命名能力之间密切相关，语篇表达能力受认知功能的影响。对命名性失语患者进行话语分析，可为语篇层面的言语康复评估和治疗提供新思路。

Abstract:

      Abstract Objective： To analyze discourse performance during discourse tasks in persons with anomic aphasia after stroke and to explore the correlation between discourse production and naming and cognitive ability. Method： A total of 29 persons with anomic aphasia and 29 healthy individuals were included. A multimedia corpus of discourse tasks including picture description and storytelling were collected from both groups. Four discourse indicators， namely， total number of words， speech rate， mean length of utterance， and lexical diversity， were counted to compare the differences in discourse indicators between persons with anomic aphasia and healthy individuals， and to analyze the correlations between the discourse indicators and naming （including object naming， word fluency， sentence completion， and responsive speech） and cognitive ability in persons with anomic aphasia. Result： The aphasia group's speech rate， mean length of utterance， and lexical diversity were significantly lower than those of the control group in both picture description and storytelling tasks. The aphasia group's total verbal output was comparable to that of the control group in picture description task （P>0.05） and significantly lower than that of the control group in storytelling （P<0.05）. There was a significant positive correlation between speech rate and object naming ability in the aphasia group in both picture description and storytelling tasks （P<0.05）. The total verbal output， speech rate and mean length of utterance in picture description task were positively correlated with orientation， attention and calculation（P<0.05）. In the task of storytelling， the total verbal output was significantly positively correlated with orientation， attention and calculation， recall and language function（P<0.05）， speech rate was significantly positively correlated with orientation（P<0.05）， and mean length of utterance was significantly positively correlated with recall ability （P<0.05）. Conclusion： Persons with anomic aphasia have significantly reduced discourse production compared to healthy individuals. The ability of object naming is strongly correlated with speech rate in discourse expression of persons with anomic aphasia. Discourse expressive ability is influenced by cognitive function. Discourse analysis of persons with anomic aphasia may provide new ideas for discourse-level language rehabilitation assessment and treatment.