声带良性疾病的嗓音声学微观特征分析

Analysis of Vocal-Acoustic Characteristics of Benign Vocal Fold Diseases

摘要: 目的：分析声带息肉、声带小结及声带囊肿的嗓音声学微观特征，探讨其在疾病鉴别诊断及病理机制研究中的价值。方法：选取60例声带良性疾病患者(息肉、小结、囊肿各20例)及20例健康对照者，采集Jitter、Shimmer、MPT、DSI及谐噪比HNR五项参数，采用单因素方差分析(ANOVA)及LSD事后检验进行组间比较。结果：疾病组与健康组在所有五项参数上均存在显著差异(P < 0.001)。具体而言，声带息肉组在基频与振幅稳定性上受损最重(Jitter: 1.172%, Shimmer: 6.864%)；声带囊肿组的嗓音噪声成分最多(HNR: 18.451 dB)；声带小结组的发声效能(MPT, DSI)优于息肉和囊肿组，但均差于健康组。结论：三种常见声带良性疾病具有特征性且可量化的嗓音声学微观表现。多参数嗓音分析可作为喉镜检查的有效补充，可为疾病的鉴别诊断、疗效评估及病理生理机制的深入理解提供客观依据。

Abstract: Objective: To analyze the micro-acoustic characteristics of voice in patients with vocal fold polyps, vocal fold nodules, and vocal fold cysts, and to explore their value in the differential diagnosis and study of pathological mechanisms. Methods: A total of 60 patients with benign vocal fold diseases (20 each with polyps, nodules, and cysts) and 20 healthy controls were enrolled. Five acoustic parameters—Jitter, Shimmer, Maximum Phonation Time (MPT), Dysphonia Severity Index (DSI), and Harmonics-to-Noise Ratio (HNR)—were collected. Inter-group comparisons were performed using one-way analysis of variance (ANOVA) and the Least Significant Difference (LSD) post-hoc test. Results: Significant differences (P < 0.001) were observed between the disease groups and the healthy control group across all five parameters. Specifically, the vocal fold polyp group exhibited the most severe impairment in fundamental frequency and amplitude stability (Jitter: 1.172%, Shimmer: 6.864%). The vocal fold cyst group demonstrated the highest level of vocal noise (HNR: 18.451 dB). The vocal fold nodule group showed better vocal efficiency (regarding MPT and DSI) than the polyp and cyst groups, but performance was still inferior to that of the healthy controls. Conclusion: The three common benign vocal fold diseases exhibit distinctive and quantifiable micro-acoustic characteristics. Multi-parameter voice analysis can serve as an effective supplement to laryngoscopy, providing an objective basis for the differential diagnosis, treatment outcome evaluation, and a deeper understanding of the pathophysiological mechanisms of these conditions.