目的 比较传统扰动方法与非线性动力学方法分析正常人、声带息肉和声带囊肿患者嗓音信号的结果,探讨非线性动力学方法的临床应用价值.方法 对20例正常受试者、26例声带囊肿患者和29例声带息肉患者,分别应用传统扰动方法测量声学指标频率微扰(jitter)、振幅微扰(shimmer)和应用非线性动力学方法重构相空间、计算关联维(D2)等,比较其结果.结果 正常受试者嗓音信号的jitter、shimmer和D2值均低于声带息肉和声带囊肿患者,差异有统计学意义(P<0.05),而声带息肉和声带囊肿患者之间jitter、shimmer和D2值的差异无统计学意义(P>0.05),声带息肉和声带囊肿患者嗓音信号的重构相空间复杂程度相似,但比正常人复杂.D2值在ROC曲线下的面积小于jitter和shimmer值,其中5例患者嗓音信号不能应用扰动方法分析,而非线性动力学方法均可分析.结论 扰动方法和非线性动力学方法对声带息肉和声带囊肿患者异常嗓音均有诊断价值,扰动方法的特异性优于非线性动力学方法,但其对信号的规则性要求较高,适用性较低,非线性动力学方法可作为扰动方法的重要补充.%Objective To assess and compare the abilities of traditional perturbation methods and nonlinear dynamic methods to describe voice from normal subjects and patients with vocal polyps and vocal cysts. Methods tion, and correlation dimension (D2) were applied to analyze the voices of 75 human subjects. Results There was a significant difference injitter, shimmer, and D2 between normal and pathological voices(P<0. 05) and no difference between patients with vocal polyps and patients with vocal cysts (P>0. 05). The phase space reconstruction was similar between patients with vocal polyps and patients with vocal cysts, but it was more difficulty than that of nor mal subjects. The area under the ROC curves for D2 was less than the areas for jitter and shimmer. 5 patients' voice signals could be analyzed by nonlinear dynamics methods but not by perturbation methods. Conclusion Both nonlin ear dynamic and traditional perturbation measures could separate normal and pathological voice, Perturbation meas ures were superior to nonlinear dynamics in distinguishing pathologies but showed a higher rate of signal and lower adaptability. Nonlinear dynamics can be used as an important supplement to perturbation measures.
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