CAJ | 학술논문

目的：探讨声带沟患者发声时最小声门面积（minimum glottal area ，MGA）和嗓音声学指标的特征及相关性。方法选择60例正常人（正常组，男女各30例）和病理型声带沟患者62例（患者组，男33例，女29例）进行频闪喉镜检查，应用配套KIPS软件计算患者发/i：/音时的MGA ；采用Dr ．Speech声学分析软件测试其基频（F0）、基频微扰（jitter）、振幅微扰（shimmer）、标准化噪声能量（normalized noise energy ，NNE）、谐噪比（harmony to noise ratio ，HNR）、信噪比（signal noise ratio ，SNR）、最长声时（maximum phonation time ，M PT ），并分别与发声时的MGA进行相关性分析。结果发/i：/音时，男性患者组 MGA （434．74±112．83像素）明显大于男性正常组（298．25±93．63像素）（P＜0．05）；女性患者组MGA（484．75±143．91像素）明显大于女性正常组（293．43±93．73像素）（ P＜0．05）；男性及女性患者发声时M G A分别与基频（ r＝0．972，P＜0．05；r＝0．928，P＜0．05）、基频微扰（ r＝0．978，P＜0．05；r＝0．910，P＜0．05）、振幅微扰（ r＝0．973，P＜0．05；r＝0．921，P＜0．05）、标准化噪声能量（ r＝0．883，P＜0．05；r＝0．960，P＜0．05）呈正相关关系，与信噪比（ r＝-0．947，P＜0．05；r＝-0．957，P＜0．05）、谐噪比（ r＝-0．959，P＜0．05；r＝-0．944，P＜0．05）、最长声时（ r＝-0．891，P＜0．05；r＝-0．936，P＜0．05）呈负相关关系。结论病理型声带沟患者发/i：/音时声门面积较正常人增大，其MGA值越大嗓音的SNR、HNR及MPT值越小，而F0、jitter、shimmer、NNE则随MGA值增大而增大。
목적：탐토성대구환자발성시최소성문면적（minimum glottal area ，MGA）화상음성학지표적특정급상관성。방법선택60례정상인（정상조，남녀각30례）화병리형성대구환자62례（환자조，남33례，녀29례）진행빈섬후경검사，응용배투KIPS연건계산환자발/i：/음시적MGA ；채용Dr ．Speech성학분석연건측시기기빈（F0）、기빈미우（jitter）、진폭미우（shimmer）、표준화조성능량（normalized noise energy ，NNE）、해조비（harmony to noise ratio ，HNR）、신조비（signal noise ratio ，SNR）、최장성시（maximum phonation time ，M PT ），병분별여발성시적MGA진행상관성분석。결과발/i：/음시，남성환자조 MGA （434．74±112．83상소）명현대우남성정상조（298．25±93．63상소）（P＜0．05）；녀성환자조MGA（484．75±143．91상소）명현대우녀성정상조（293．43±93．73상소）（ P＜0．05）；남성급녀성환자발성시M G A분별여기빈（ r＝0．972，P＜0．05；r＝0．928，P＜0．05）、기빈미우（ r＝0．978，P＜0．05；r＝0．910，P＜0．05）、진폭미우（ r＝0．973，P＜0．05；r＝0．921，P＜0．05）、표준화조성능량（ r＝0．883，P＜0．05；r＝0．960，P＜0．05）정정상관관계，여신조비（ r＝-0．947，P＜0．05；r＝-0．957，P＜0．05）、해조비（ r＝-0．959，P＜0．05；r＝-0．944，P＜0．05）、최장성시（ r＝-0．891，P＜0．05；r＝-0．936，P＜0．05）정부상관관계。결론병리형성대구환자발/i：/음시성문면적교정상인증대，기MGA치월대상음적SNR、HNR급MPT치월소，이F0、jitter、shimmer、NNE칙수MGA치증대이증대。
Objective To investigate the voicing acoustic characteristics of sulcus vocalis patients with mini-mum glottal area(MGA) .Methods 60 normal subjects (30 male ,30 female) ,and 62 subjects with sulcus vocalis (33 male and 29 female)were recruited .They all had stroboscopic laryngoscopy ,and had MGA measured when say-ing /i:/using software supporting KIPS .The acoustic parameters consisted of vocal cord fundamental frequency (F0) ,jitter and shimmer ,normalized noise energy ( NNE) ,harmony to noise ratio (HNR) and signal noise ratio (SNR) ,maximum phonation time(MPT) and respectively make correlation analysis with voice MGA .Results The voicing MGA of male patients with sulcus vocalis was 434 .74 ± 112 .83 ,larger than the males with normal vocalis 298 .25 ± 93 .63 .This was statistically significant (P<0 .05) .The voicing MGA of females with sulcus vocalis was (484 .75 ± 143 .91) ,significantly larger than those of females with normal vocalis (293 .43 ± 93 .73) and the differ-ence was statistically significant (P<0 .05) .The voicing MGA on both males and females with sulcus vocalis was noticeably relation to the F0 (r=0 .972 ,P<0 .05) and (r=0 .928 ,P<0 .05) ,Jitter (r=0 .978 ,P<0 .05) and (r=0 .910 ,P<0 .910) and Shimmer (r=0 .973 ,P<0 .05) and (r=0 .921 ,P<0 .05) ,normalized noise energy(r=0 .883 ,P<0 .05) and (r=0 .960 ,P<0 .05) ;and negative relation to the signal noise ratio (r= -0 .947 ,P<0 .05) and (r = -0 .957 ,P<0 .05) ,signal noise ratio (r= -0 .959 ,P<0 .05) and (r= -0 .944 ,P<0 .05) ,max-imum phonation time (r= -0 .891 ,P<0 .05) and (r= -0 .936 ,P<0 .05) .Conclusion Patients with pathological sulcus vocalis have glottal areas larger than normal .Acoustic analysis of the voices of the sulcus vocalis can be used as an objective laboratory examination .