成年男性吸烟者的噪音变化及空气动力学分析

发布时间：2018-05-02 06:25

本文选题：声学分析 + 非线性动力学分析　；参考：《复旦大学》2010年博士论文

【摘要】： 吸烟引起呼吸道疾病发生率增高,导致喉部的各类疾病例如喉部慢性炎症,返流性喉炎,任克氏间隙水肿,从而引起各种嗓音疾病。目前已经有研究对吸烟引起的嗓音基频下降进行了报道,空气动力学方面研究发现最长发声时间下降,但对于吸烟相关嗓音分析的综合性研究较少。非线性动力学研究克服了传统嗓音研究的缺点,目前已经用于大量的病理性及非病理的嗓音样本中,但是吸烟相关嗓音的非线性动力学分析仍然是空白。本文拟对吸烟者及非吸烟者的嗓音进行全面的微扰分析、非线性动力学分析以及空气动力学分析。在此基础上,定量探索吸烟对于喉功能引起的损害的性质,以期建立无创性评估吸烟者嗓音及声带受损程度的检查方法,从而对无症状吸烟者进行宣教,促进无烟运动。一、成年男性吸烟者的嗓音微扰分析及非线性动力学分析目标：吸烟导致嗓音变化,若使吸烟者及时察觉嗓音异常改变,可鼓励其进行戒烟。嗓音变化通常是声带病理改变的首发表现。对嗓音的评估研究主要集中在传统的嗓音分析,然而,非线性动力学分析方法已经被证明是客观可靠的评估嗓音的方法。我们将这两种方法一起用于分析正常者及吸烟者的嗓音。方法：本项目为前瞻性研究。共包括73名研究对象,36名非吸烟者及37名吸烟者。每个研究对象录制一段持续的元音发声。数据使用了嗓音分析及关联维数分析。结果用Mann-Whitney秩和检验,回归分析及受试者工作特征(Receiver Operating Characteristics, ROC)对各项研究结果进行分析。结果：吸烟组的D2值明显要比非吸烟组高(p0.001),频率微扰和振幅微扰分析的参数在抽烟组中较高。逻辑回归分析提示关联维数(Correlation Dimension, D2)有较高的预测能力,ROC分析两种方法未发现有显著性差异。讨论：本研究提示关联维数对于吸烟相关的变化是非常敏感的,临床上可以提示嗓音异常。进一步研究可以集中于用非线性动力学分析方法创建正常嗓音数据库,建立标准阈值,监控吸烟所致的嗓音变化。二、成年男性吸烟者的空气动力学分析目标:空气动力学反映的是喉作为传感器将声门下空气动力能转换为声能时的一系列参数。最小发声气流(Phonation Threshold Flow, PTF)作为发声所需最小气流,对于喉部组织、声门结构的微小变化较敏感。我们将比较男性吸烟者与非吸烟者的一系列空气动力学参数,包括PTF、平均气流(Mean Flow Rate, MFR)等,以研究吸烟引起的喉部结构改变。方法：本项目为前瞻性研究。共包括73名研究对象,36名非吸烟者及37名吸烟者。每个研究对象分别进行空气动力学测量。结果用Mann-Whitney秩和检验进行分析。结果：可见吸烟组的声门下压(Subglottal Pressure, SGP)平均均值高于非吸烟组,吸烟组的PTF以及MFR均值低于非吸烟组,但是无统计学意义(p0.05)。讨论：影响空气动力学结果的因素较多,PTF作为新的空气动力学参数,运用于临床还需要进一步的完善操作规范和技术。进一步研究可以集中于将空气动力学与临床的声学、影像学等结合,以达到全面定量诊断吸烟对于喉功能的影响的作用。
[Abstract]:Smoking causes an increase in the incidence of respiratory diseases, causing various diseases such as chronic larynx inflammation, reflux laryngitis, and Kirschner's gap edema, resulting in a variety of voice diseases. There are few comprehensive studies on smoking related voice analysis. The nonlinear dynamics study overcomes the shortcomings of the traditional voice research. It has been used in a large number of pathological and non pathological voice samples, but the nonlinear dynamic analysis of smoking related voices is still blank. The voice of smokers and non smokers is proposed in this paper. On the basis of the comprehensive perturbation analysis, nonlinear dynamic analysis and aerodynamics analysis, the nature of the damage caused by smoking in the larynx was quantitatively explored in order to establish a noninvasive method to assess the degree of damage of the voice and vocal cord of smokers, so as to promote the smokeless smoker and promote the smokeless movement.
First, the voice perturbation analysis and nonlinear dynamic analysis of adult male smokers: smoking leads to voice changes. If smokers detect abnormal voice changes in time, they can be encouraged to quit smoking. Voice changes are usually the first manifestation of vocal pathological changes. The evaluation of voice is mainly focused on traditional voice analysis, but However, the nonlinear dynamic analysis method has been proved to be an objective and reliable method of voice evaluation. We use these two methods to analyze the voice of normal people and smokers. Methods: this project is a prospective study. A total of 73 subjects, 36 non smokers and 37 smokers are included in this project. Each research object is recorded for a continuous period of time. The data used voice analysis and correlation dimension analysis. Results the results were analyzed with Mann-Whitney rank sum test, regression analysis and Receiver Operating Characteristics (ROC). Results: the D2 value of smoking group was significantly higher than that of non smoking group (p0.001), frequency perturbation and amplitude perturbation. The parameters of the analysis were higher in the smoking group. The logistic regression analysis suggested that the correlation dimension (Correlation Dimension, D2) had higher prediction ability. The two methods of ROC analysis did not find significant difference. The study can focus on creating a normal voice database using nonlinear dynamic analysis, establishing standard thresholds, and monitoring voice changes caused by smoking.
Two, the aerodynamics analysis of adult male smokers: Aerodynamics reflect a series of parameters when the throat is used as a sensor to convert the aerodynamic energy of the glottal into sound energy. The minimum sound flow (Phonation Threshold Flow, PTF) is the minimum air flow required for the sound, and the minute changes in the glottal structure are more sensitive to the larynx. We will compare a series of aerodynamic parameters between male smokers and non smokers, including PTF, Mean Flow Rate (MFR), etc. to study the structural changes in the larynx caused by smoking. Methods: this project is a prospective study. A total of 73 subjects, 36 non smokers and 37 smokers were included. The results were analyzed with the Mann-Whitney rank sum test. Results: the mean mean value of subglottic pressure (Subglottal Pressure, SGP) in smoking group was higher than that of non smoking group, and the mean value of PTF and MFR in smoking group was lower than that of non smoking group, but there was no statistical significance (P0.05). The factors affecting the aerodynamic results were more than that of smoking group (P0.05). PTF, as a new aerodynamic parameter, needs further improvement of operational specifications and techniques in clinical practice. Further research can be focused on the combination of aerodynamics and clinical acoustics and imaging to achieve a comprehensive and quantitative diagnosis of the effect of smoking on laryngeal function.

【学位授予单位】：复旦大学
【学位级别】：博士
【学位授予年份】：2010
【分类号】：R767.92

【参考文献】