新疆维吾尔自治区人民医院
新疆少数民族科技人才特殊培养计划科研项目，编号：2020D03010
1.Ear,Nose and Throat Diagnosis and Treatment Center of Xinjiang Uygur Autonomous Region People'2.'3.s Hospital
- 摘要 | |
- 访问统计 |
- 参考文献 | |
- 引证文献 |
目的:分析早期痉挛性发音障碍(SD)动态频谱特征,及对临床疗效和预后的评估价值。方法:2022年1月至2024年1月我院诊断早期SD患者65例为研究对象,接受肉毒素A喉肌注射,根据临床疗效分为有效组58例和无效组7例。比较2组患者治疗前后动态频谱特征、嗓音障碍指数量表(VHI-30)和改良 Frenchay 构音障碍评定(mFDA)的差异。多因素Logistic回归分析与SD患者临床疗效有关的因素。ROC曲线评估预测SD临床疗效的指标价值。结果:与治疗前相比,2组患者治疗后振幅微扰、基频微扰、读标准化段落的总耗时及嗓音中断次数比治疗前显著降低,而DSI、MPT和声强范围升高(P<0.05)。与无效组相比,有效组患者中重度比例减少,治疗前振幅微扰和基频微扰降低,DSI、MPT和声强范围增加(P<0.05)。多因素Logistic回归显示,痉挛严重程度、治疗前DSI和声强范围是预测临床疗效的重要指标(P<0.05)。ROC曲线显示,DSI和声强范围预测临床疗效的曲线下面积(AUC)分别为0.853和0.815(P<0.05)。结论:早期SD患者的动态频谱特征及定量参数对疾病诊断和评估临床疗效具有重要的应用价值。
Objective: To analyze the dynamic spectral characteristics of patients with early spasmodic dysphonia (SD) and its value in evaluating clinical prognosis. Methods: 65 patients diagnosed with early SD in our hospital were collected from January 2022 to January 2024. All patients were divided into two groups, that were effective group (n=58) and ineffective group (n=7). The indexes of the dynamic frequency spectrum characteristics, voice handicap index (VHI-30) and modified French articulation disorder assessment (mFDA) were measured at pre- and post-therapy and compared between two groups. The risk degrees of the clinical indexes to the clinical effect in patients with SD were analyzed by multivariate Logistic regression analysis. The diagnostic values of the clinical indexes to the prognosis in patients with SD were analyzed by receiver operating characteristic curves (ROC). Results: Compared to pre-therapy, the indexes of shimmer, jitter, total time spent on reading standardized paragraphs, and the number of voice interruptions at post-therapy in 2 groups were lower (P<0.05), and the indexes of DSI, MPT, and sound intensity range at post-therapy in 2 groups were higher (P<0.05). Compared to ineffective group, the index of the proportion of moderate and severe symptoms in the effective group was lower (P<0.05), and the indexes of shimmer and jitter at pre-therapy in the effective group was lower (P<0.05), but the DSI, MPT, and sound intensity range in the effective group was higher (P<0.05). Multivariate logistic regression showed that the severity of spasms DSI, and range of sound intensity before treatment were important indicators for predicting clinical efficacy (P<0.05).Receiver operating characteristic (ROC) curve showed that area under curve (AUC) of DSI and sound intensity range for predicting clinical efficacy were 0.853 and 0.815, respectively (P<0.05). Conclusion: The dynamic spectral characteristics and quantitative parameters of early SD patients have important value for disease diagnosis and evaluation of clinical efficacy.
