目的 通过对嗓音元音分析及嗓音障碍严重指数的研究,评估其是否可以用于鉴别诊断临床常见嗓音疾病.方法 对811例嗓音疾病患者的持续元音测试和音域测试结果进行统计学分析,根据诊断将受试者分成8个疾病组.在对数据进行初步分析后,选择方差分析中的Dunnett T3检验方法进行组间的两两对比分析,检验标准α=0.05.结果 对数据进行单因素方差分析,结果显示男性受试者F0min、Jitter、Shimmer、SPLmax各组间存在统计学差异(P＜0.05).女性受试者F0、Jitter、F0max、F0min、SPLmax、SPLmin各组间存在显著的统计学差异(P＜0.05).进一步对各组进行两两比较,男性受试者除喉癌组与任克间隙水肿组、声带息肉组与任克间隙水肿组的Jitter和F0max,声带白斑组与任克间隙水肿组的F0max,息肉组与喉癌组的SPLmax存在统计学差异外(P＜0.05),其余各参数在任意两组间的差异均无统计学意义(P＞0.05).女性受试者除囊肿组与声带麻痹组、声带小结组与声带麻痹组的SPLmax,声带息肉组与声带小结组的DSI存在统计学差异外,其余各参数在任意两组间的差异均无统计学意义(P＞0.05).结论 嗓音分析可用来评估发声的障碍程度,但以目前所用参数尚不能有效鉴别诊断喉部疾病.%Objective To determine whether the vocal vowel analysis and dysphonia severity index (DSI) can be applied to the differential diagnosis of common laryngeal diseases.Methods Statistical analysis was performed on sustained vowel test and range test of vocal acoustic analysis in 811 patients with laryngeal diseases.The patients were divided into 8 groups according to the diagnosis.One-Way ANOVA test was used to analyze the data,and the Dunnett T3 test was selected to analyze the comparisons between the two groups,the test standard alpha =0.05.Results The results of One-Way ANOVA test showed significant statistical differences in F0min,Jitter,Shimmer,and SPLmax among groups in male patients (all P ＜0.05),and in F0,Jitter,F0max,F0min,SPLmax,SPLmin among groups in female patients (all P ＜ 0.05).Dunnett T3 test revealed no statistically differences in the parameters of the vocal acoustic analysis between any two laryngeal disease groups except those of Jitter,F0max between laryngeal carcinoma group and Reinke's edema group,vocal polyp group and Reinke's edema group,F0max between vocal leukoplakia group and Reinke's edema group,SPLmax between vocal polyp group and laryngeal carcinoma group in male patients,and those of SPLmax between vocal cyst group and vocal cord paralysis group,vocal nodules group and vocal cord paralysis group,DSI between vocal polyp group and vocal nodules group in female patients.Conclusion Vocal acoustic analysis can be used to assess the level of dysphonia,but the current parameters can't be applied to effectively differentiate laryngeal diseases.
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