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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。
Objective: To study the changes of vocal function in patients with myasthenia gravis and the role of computer voice analysis system in the diagnosis and evaluation of patients with myasthenia gravis. Methods: Eighty-three patients with myasthenia gravis were divided into two groups: type I (ocular muscle type) and type II (systemic type), and each group was divided into male and female groups by sex. Forty cases of age and gender were matched Healthy adults as control group. Computer acoustics tests were performed before and after Neostigmine test and after the end of routine treatment. The acoustic test parameters included fundamental frequency (F0), frequency jitter, amplitude shimmer and standard glottal noise energy ( NNE). Statistical methods using independent sample data t test and paired data t test. Results: The NNE value of type Ⅱ MG was higher in male and female than in control group (all P <0.05). There was significant difference between male and female in group F0 All were statistically significant (P <0.01 and P <0.05, respectively). Neostigmine test and routine treatment, F0 and NNE values were reduced, compared with the pre-test, the difference was statistically significant (P <0.01). CONCLUSIONS: Patients with type 2 myasthenia gravis have abnormal vocal function and vocalization parameters are changed, showing an increase in F0 and NNE values, which decreases as their condition improves. Computer acoustics test for type Ⅱ myasthenia gravis in patients with clinical diagnosis and efficacy observation has some auxiliary reference value.