脳血管障害によるディサースリア患者の発声発語器官の運動機能と血清アルブミン値の関係

The relationship between the motor function of speech components and the serum albumin level in patients with dysarthria caused by cerebrovascular accident

　本研究の目的は，標準ディサースリア検査の評価点と血清アルブミン値をもとに，発声発語器官の運動機能と栄養状態の関係を明らかにすることである．脳血管障害によるディサースリア患者20名を血清アルブミン値3.5g/dl以上群と未満群の2群に分けたうえで，呼吸，発声，鼻咽腔閉鎖，口腔構音(運動範囲，交互反復運動での速度，筋力)の各機能および発話明瞭度，発話の自然度，声量の低下の合計9項目についてMann-WhitneyのU検定を用いて両群を比較した．結果，呼吸機能，発声機能，口腔構音機能の筋力，声量の低下の評価点が3.5g/dl未満群で有意に低下していた(いずれもp＜0.05)．今回の研究により脳血管障害によるディサースリア患者の低栄養状態は発声発語器官の運動機能に影響し，発話には声量の低下として現れることがわかった．

　The purpose of this study was to examine dysarthria patients and look for any relationship between patients' motor function of speech components, measured using the Assessments of Motor Speech for Dysarthria(AMSD), and patients' nutritional status, as indicated by their serum albumin level. Twenty individuals with dysarthria caused by cerebrovascular accidents were divided into two groups: one with serum albumin level ≥ 3.5g/dl(n＝10) and the other with serum albumin level＜3.5g/dl group(n＝10). The two groups were compared for a total of 9 items using Mann-Whitney's U test: 6 AMSD items including respiratory function, phonation, velopharyngeal closure, oral articulation(range of movement, diadochokinetic rate, and muscle strength) and 3 items of auditory evaluation of speech, namely speech intelligibility, speech naturalness, and reduced loudness levels. The results showed that the scores were significantly lower in the group with low serum albumin levels, with regard to respiration, phonation, muscle strength of oral articulation, and reduced loudness levels. These data suggest that malnutrition in individuals with dysarthria caused by cerebrovascular accidents adversely affects the motor function of speech components, which manifests itself most obviously as reduced loudness in speech.