嗓音障碍RBH听感知评估系统中文版的研究

发布时间：2018-07-11 09:38

本文选题：嗓音障碍 + 声学测试　；参考：《第二军医大学》2012年硕士论文

【摘要】：目的：以德语嗓音障碍RBH听感知评估系统为参考,对RBH听感知评估系统进行中文版化研究,并初步制定RBH听感知评估系统中文版的标准培训光碟,为嗓音障碍RBH主观听感知中文版化评估系统的临床应用奠定基础。方法：(1)研究对象：嗓音障碍组79例,正常嗓音组15例。(2)主观听感知评估：采用德国RBH主观听感知评估系统中的R,B,H主观参数对受试者进行主观等级评分；每个评估参数分为4个等级：0代表正常,1代表轻度异常,2代表中度异常,代表重度异常。(3)嗓音客观参数的测量：采用Davis2.5和Pratt软件对受试者的客观参数Jitter、Shimmer、HNR、MPT和DSI的相关数值进行测量。(4)统计学分析：首先对R,B,H进行信度检验,包括评委自身一致性和评委间一致性；再比较H每相邻两个等级之间客观嗓音声学参数的差异,进行效度检验；最后将R,B,H与DSI进行一致性检验,筛选出DSI与H等级完全一致的样本作为RBH评估系统中文版的标准培训材料。采用SPSS11.5统计软件,一致性检验时选用Kappa系数,效度检验使用Mann-Whitney Test检验。结果：(1)以RBH作为主观听感知参数,评委自身一致性以Kappa系数值表示,其数值为0.428-0.601,说明5位评委前后两次对RBH这个整体参数评估的一致性好；评委间一致性以组内相关系表示,2次评估的组内相关系数值分别为0.74-0.79,0.689-0.762,证明第1次评估时5位评委间的一致性和第2次评估时5位评委间的一致性均好。(2)主观听感知参数R,B,H与客观参数Jitter、 Shimmer、HNR、MPT和DSI等之间的相关性分析结果显示：①主观听感知参数R,B,H与Jitter、Shimmer、HNR、MPT及DSI之间均具有显著的相关性,差异有统计学意义(P均0.01)；②R与Jitter和HNR的相关性最强,相关系数分别为0.551、0.499、0.550；③B与MPT,H与DSI呈高度负相关,相关系数分别达0.620和0.613。说明主观评估的结果与客观结果大体上一致。(3)主观听感知参数R,B,H的4个等级中每相邻2个等级之间的Jitter、Shimmer、HNR、 MPT及DSI比较差异均有统计学意义(p均0.05),说明R,B,H的等级划分是合理、正确的。(4)通过R,B,H与DSI之间的一致性分析,将H与DSI完全一致的42例嗓音样本纳入标准培训光碟中,男女组成在各等级中基本平均分布,疾病谱广泛全面,可作为RBH听感知评估系统中文版的标准培训光碟,也为嗓音障碍RBH主观听感知评估系统中文版标准化的建立提供蓝本。结论：(1)以RBH主观听感知评估系统中文版评估参数评估嗓音障碍患者,评委自身一致性以及评委间一致性均好。(2)主观评估的R,B,H参数结果与客观评估参数的结果大体上一致。(3)R,B,H的等级划分是合理、正确的。(4)初步制定的RBH听感知评估系统中文版的标准培训光碟比较合理、可行,为进一步开展全国多中心研究及临床应用打下良好的基础。
[Abstract]:Objective: to study the Chinese version of the RBH auditory perception evaluation system based on the RBH auditory perception evaluation system for German voice disorders, and to develop a Chinese version of the standard training disc for the RBH auditory perception assessment system. To lay a foundation for the clinical application of RBH subjective auditory perception evaluation system. Methods: (1) subjects: 79 patients in the voice disorder group and 15 in the normal voice group. (2) subjective auditory perception assessment: the subjective parameters of RNBHs in the RBH subjective auditory perception evaluation system in Germany were used to evaluate the subjective grade of the subjects. Each evaluation parameter was divided into 4 grades: 0: 0 for normal and 1 for mild abnormality and 2 for moderate abnormality. (3) Measurement of objective voice parameters: using Davis2.5 and Pratt software to measure the relative values of the objective parameters Jitteri ShimmerHNRGMPT and DSI. (4) Statistical analysis: first, the reliability of RGN BH was tested. Including the consistency of the judges themselves and the consistency between the judges; then compare the differences of the objective voice acoustic parameters between the two adjacent grades of H, and test the validity; finally, we test the consistency between RBHs and DSI. Samples of DSI and H grades are selected as standard training materials for the Chinese version of RBH evaluation system. Using SPSS 11.5 statistical software, Kappa coefficient and Mann-Whitney Test were used for consistency test and validity test respectively. Results: (1) using RBH as the subjective auditory perception parameter, the consistency of the judges was expressed as the Kappa coefficient, whose value was 0.428-0.601, which indicated that the evaluation of RBH was consistent twice before and after the 5-bit judges; The intra-group correlation coefficient values of the two evaluations were 0.74-0.79 / 0.689-0.762respectively, which proved that the consistency of the five judges in the first evaluation and the consistency among the five judges in the second evaluation were good. (2) subjective sense of hearing. The results of correlation analysis between the known parameter RG BHH and objective parameters Jitter, ShimmerHNRNRT and DSI showed that the subjective auditory perception parameter RGBH1 had significant correlation with JitterShimmerHNRMMPT and DSI. There was significant difference (P0.01) in the correlation between jitter and HNR. The correlation coefficient was 0.551U 0.4990.5053B and MPTH was negatively correlated with DSI, and the correlation coefficients were 0.620 and 0.613respectively. The results of subjective assessment are consistent with objective results generally. (3) there are significant differences in Jitter ShimmerHNR, MPT and DSI between each of the four grades of subjective auditory perception parameter RG BNH (p 0.05). (4) through the consistency analysis between RDSI and RDSI, 42 voice samples with the same H and DSI were included in the standard training disc. The composition of male and female was distributed equally in all levels, and the disease spectrum was extensive and comprehensive. It can be used as the standard training disc of RBH auditory perception evaluation system in Chinese, and it can also provide a blueprint for the standardization of the Chinese version of RBH subjective auditory perception evaluation system for voice disorders. Conclusion: (1) the evaluation parameters of RBH subjective auditory perception evaluation system were used to evaluate patients with voice disorders. The consistency of the judges themselves and the consistency among the judges are good. (2) the results of the subjective evaluation of RGB-H parameters are generally consistent with the results of the objective evaluation parameters. (3) the classification of the RGB-H parameters is reasonable. (4) the Chinese version of RBH auditory perception evaluation system is reasonable and feasible, which lays a good foundation for further multi-center research and clinical application.
【学位授予单位】：第二军医大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R767.92

【参考文献】