本文選題：維吾爾語(yǔ) + 失語(yǔ)癥檢查法��； 參考：《新疆醫(yī)科大學(xué)》2013年博士論文

【摘要】：第一部分：維吾爾語(yǔ)失語(yǔ)癥檢查法的標(biāo)準(zhǔn)化研究 目的：維吾爾語(yǔ)失語(yǔ)癥檢查法是翻譯漢語(yǔ)失語(yǔ)檢查法,按照維吾爾語(yǔ)詞句用語(yǔ)的習(xí)慣和規(guī)則進(jìn)行少量修改,適用于維吾爾語(yǔ)語(yǔ)言環(huán)境,并能用于維吾爾語(yǔ)失語(yǔ)癥的診斷和治療評(píng)估用途的評(píng)定量表。本部分主要研究維吾爾語(yǔ)失語(yǔ)癥檢查法的信度和效度。方法：把高素榮的漢語(yǔ)失語(yǔ)檢查法翻譯成維吾爾語(yǔ),根據(jù)維吾爾語(yǔ)語(yǔ)言特點(diǎn)在某些方面做了適當(dāng)改動(dòng)(如復(fù)述、聽(tīng)字辨認(rèn)和書(shū)寫(xiě)),但總體結(jié)構(gòu)不變。應(yīng)用專家評(píng)議法對(duì)維吾爾語(yǔ)失語(yǔ)癥檢查法進(jìn)行了3輪評(píng)議及修定,經(jīng)語(yǔ)言調(diào)適和預(yù)測(cè)試,并再次進(jìn)行了維漢回譯。把它應(yīng)用于檢測(cè)了134例維吾爾族正常人和104例維吾爾族腦卒中后失語(yǔ)患者的語(yǔ)言功能,語(yǔ)言功能評(píng)定由1名經(jīng)過(guò)培訓(xùn)的維吾爾族研究生于患者入院時(shí)進(jìn)行評(píng)定,其中30例患者于一周后再次對(duì)其語(yǔ)言功能進(jìn)行評(píng)定。匯總數(shù)據(jù)運(yùn)用因子分析法、Spearman秩相關(guān)性分析等方法檢驗(yàn)維吾爾語(yǔ)失語(yǔ)癥檢查法的結(jié)構(gòu)效度、內(nèi)在信度、重測(cè)信度和分半信度。結(jié)果：維漢回譯后,與漢語(yǔ)失語(yǔ)檢查法的差異率小于10%。結(jié)構(gòu)效度：KMO值為0.917,bartlett球形檢驗(yàn)的P值小于0.005,說(shuō)明適合因子分析,以主成分分析法及最大方差正交旋轉(zhuǎn)法,按3個(gè)因子提取公因子,分別命名為閱讀因子、書(shū)寫(xiě)因子,聽(tīng)理解因子,共解釋了81.03%的方差。內(nèi)在信度：將量表內(nèi)容的24方面拆分為四部分,口語(yǔ)表達(dá)、聽(tīng)理解、閱讀和書(shū)寫(xiě),分別計(jì)算各部分的Cronbach α為0.969、0.922、0.966、0.924,總Cronbach α系數(shù)為0.978。重測(cè)信度：除書(shū)寫(xiě)方面的2個(gè)項(xiàng)目的相關(guān)系數(shù)低于0.7外,量表其他22項(xiàng)的重測(cè)相關(guān)系數(shù)都大于0.8。維吾爾語(yǔ)失語(yǔ)癥檢測(cè)量表的分半信度為0.906。結(jié)論：本研究認(rèn)為維吾爾語(yǔ)失語(yǔ)癥檢查法具有良好的效度、信度；能對(duì)維吾爾語(yǔ)失語(yǔ)癥進(jìn)行診斷和分類,定量地反映維吾爾語(yǔ)失語(yǔ)癥患者的語(yǔ)言功能狀況,適合在臨床康復(fù)中應(yīng)用。 第二部分：各型維吾爾語(yǔ)失語(yǔ)癥的病態(tài)語(yǔ)言特點(diǎn)研究 目的：旨在通過(guò)對(duì)維吾爾族失語(yǔ)癥病例進(jìn)行系統(tǒng)地觀察和評(píng)定,應(yīng)用神經(jīng)心理學(xué)方法,系統(tǒng)分析各型維吾爾語(yǔ)失語(yǔ)癥的病態(tài)語(yǔ)言特點(diǎn),并與漢語(yǔ)失語(yǔ)癥進(jìn)行比較,分析二者病態(tài)語(yǔ)言特點(diǎn)的差異性；初步分析各型維吾爾語(yǔ)失語(yǔ)癥、失語(yǔ)后書(shū)寫(xiě)障礙類型與腦損害部位的關(guān)系,為臨床維吾爾語(yǔ)失語(yǔ)癥的診斷和康復(fù)提供理論依據(jù)。方法：采用維吾爾語(yǔ)失語(yǔ)癥檢查法評(píng)定符合納入和排除標(biāo)準(zhǔn)的104例維吾爾族腦卒中后失語(yǔ)癥患者,漢語(yǔ)失語(yǔ)檢查法評(píng)定81例漢語(yǔ)失語(yǔ)癥患者,用傳統(tǒng)的神經(jīng)心理學(xué)方法對(duì)其評(píng)定結(jié)果的聽(tīng)、說(shuō)、讀、寫(xiě)進(jìn)行系統(tǒng)分析,并比較二者的差異性。結(jié)果：(1)運(yùn)動(dòng)性失語(yǔ)表現(xiàn)為非流利性失語(yǔ)口語(yǔ),呈電報(bào)式,實(shí)質(zhì)詞為主,語(yǔ)音障礙明顯,理解較好,復(fù)述障礙,閱讀和書(shū)寫(xiě)亦有不同程度障礙。經(jīng)皮質(zhì)運(yùn)動(dòng)性失語(yǔ)總體上與運(yùn)動(dòng)性失語(yǔ)類似,但復(fù)述好。(2)感覺(jué)性失語(yǔ)表現(xiàn)為流利性失語(yǔ)口語(yǔ),出現(xiàn)較多錯(cuò)語(yǔ)及新語(yǔ),理解嚴(yán)重障礙,復(fù)述、命名、閱讀和書(shū)寫(xiě)障礙。經(jīng)皮質(zhì)感覺(jué)性失語(yǔ)總體與感覺(jué)性失語(yǔ)類似但復(fù)述好。(3)經(jīng)皮質(zhì)混合性失語(yǔ)可以看作經(jīng)皮質(zhì)運(yùn)動(dòng)性失語(yǔ)和經(jīng)皮質(zhì)感覺(jué)性失語(yǔ)并存,非流利型失語(yǔ)口語(yǔ),錯(cuò)語(yǔ)較明顯,聽(tīng)理解障礙雖重,但較感覺(jué)性失語(yǔ)輕,復(fù)述功能保留,但不完整。(4)命名性失語(yǔ)表現(xiàn)為流利性失語(yǔ)口語(yǔ),嚴(yán)重命名障礙,理解、復(fù)述、閱讀、書(shū)寫(xiě)障礙輕。(5)完全性失語(yǔ)者所有的語(yǔ)言功能均嚴(yán)重受損,大多數(shù)患者僅能發(fā)刻板單音或單詞,僅理解1-2個(gè)簡(jiǎn)單指令。(6)基底節(jié)性失語(yǔ)多為輕至中度口語(yǔ)流暢性障礙,說(shuō)話費(fèi)力緩慢,詞與詞間缺乏連貫性,構(gòu)音障礙,理解輕度障礙,復(fù)述可正常,閱讀及書(shū)寫(xiě)中度障礙。(7)丘腦性失語(yǔ)多表現(xiàn)為低音調(diào),語(yǔ)量減少,找詞困難,構(gòu)音中度障礙,命名和理解輕度障礙,復(fù)述可正常。維吾爾語(yǔ)人的語(yǔ)言優(yōu)勢(shì)半球與漢人一樣都在左側(cè)大腦半球,其中62.5%的失語(yǔ)癥是由經(jīng)典的語(yǔ)言中樞病變引起,以運(yùn)動(dòng)性失語(yǔ)、完全性失語(yǔ)和經(jīng)皮質(zhì)混合性失語(yǔ)較為符合。維吾爾語(yǔ)失語(yǔ)癥后書(shū)寫(xiě)障礙類型與漢語(yǔ)的基本一致,包括語(yǔ)言性書(shū)寫(xiě)障礙和非語(yǔ)言性書(shū)寫(xiě)障礙兩大類。維、漢兩組均以失語(yǔ)性書(shū)寫(xiě)障礙多見(jiàn),其病灶部位分布較廣;維語(yǔ)組中失用性失寫(xiě)累及左頂葉,惰性失寫(xiě)累及左額葉及其深部白質(zhì),鏡像書(shū)寫(xiě)病變部位散在分布于左額、頂葉和基底節(jié)區(qū)。結(jié)論：各型維吾爾語(yǔ)失語(yǔ)癥的病態(tài)語(yǔ)言特點(diǎn)不同,但同一類型維吾爾語(yǔ)、漢語(yǔ)失語(yǔ)癥的病態(tài)語(yǔ)言特點(diǎn)基本一致。不同的維吾爾語(yǔ)書(shū)寫(xiě)障礙類型有不同的病理書(shū)寫(xiě)特點(diǎn),但同一類型維吾爾語(yǔ)、漢語(yǔ)書(shū)寫(xiě)障礙的病理書(shū)寫(xiě)特點(diǎn)基本一致。維吾爾族人的語(yǔ)言優(yōu)勢(shì)半球與漢人的一樣在左側(cè)大腦半球；各型維吾爾語(yǔ)失語(yǔ)癥、失語(yǔ)后書(shū)寫(xiě)障礙類型與腦損傷部位有一定關(guān)系。 第三部分：維吾爾族、漢族正常人腦激活區(qū)差異性的fMRI研究 目的：應(yīng)用fMRI中的BOLD技術(shù),采用兩種語(yǔ)言任務(wù)探索母語(yǔ)為吾爾語(yǔ)正常人的腦語(yǔ)言功能區(qū)。同時(shí)比較維漢正常人在執(zhí)行兩種語(yǔ)言任務(wù)時(shí)的腦激活差異區(qū)。方法：選擇健康志愿者30例,母語(yǔ)為維吾爾語(yǔ)者15例,母語(yǔ)為漢語(yǔ)者15例,均為右利手,語(yǔ)言功能正常。使用美國(guó)公司GE signa3.OT超導(dǎo)磁共振成像系統(tǒng),用8通道頭線圈接收信號(hào)。首先用3D薄層掃描序列,獲取顱腦橫軸位T1加權(quán)像,再用梯度回波平面成像序列,進(jìn)行BOLD信號(hào)的數(shù)據(jù)采集。語(yǔ)言任務(wù)采用視覺(jué)呈現(xiàn)的方式,每個(gè)受試者在進(jìn)行掃描時(shí)執(zhí)行兩種語(yǔ)言任務(wù)：語(yǔ)義辨別和動(dòng)詞產(chǎn)生，，對(duì)照時(shí)注視屏幕上顯示“+”號(hào),采用默讀方法完成試驗(yàn)任務(wù)。用SPM5進(jìn)行后處理。影像分析使用SPM5進(jìn)行個(gè)體分析和組分析,統(tǒng)計(jì)閾值設(shè)為矯正的p-≤0.05,且體素≥6,FDR校正之后認(rèn)為差異有統(tǒng)計(jì)學(xué)意義。組內(nèi)和組間數(shù)據(jù)采用單樣本和雙樣本t檢驗(yàn)進(jìn)行統(tǒng)計(jì)學(xué)分析。結(jié)果：維吾爾語(yǔ)正常人語(yǔ)義辨別任務(wù)激活腦區(qū)主要在左側(cè)額中回、頂上小葉、枕下回、右側(cè)枕中回有不同程度的激活,左側(cè)大腦半球激活腦區(qū)明顯多于右側(cè)大腦半球。維、漢正常人語(yǔ)義辨別任務(wù)時(shí)激活的差異腦區(qū)主要在左側(cè)扣帶回(BA23)和楔前葉,維吾爾語(yǔ)組在這兩個(gè)區(qū)域表現(xiàn)出顯著正激活,而漢語(yǔ)組在該區(qū)激活相對(duì)較弱,兩者差異具有統(tǒng)計(jì)學(xué)意義。維吾爾語(yǔ)正常人動(dòng)詞產(chǎn)生任務(wù)激活腦區(qū)主要為雙側(cè)額下回、額中回、頂下小葉、前扣帶回、輔助運(yùn)動(dòng)區(qū)、左側(cè)基底節(jié)區(qū)、中央前回、左側(cè)顳上回、顳中回、梭狀回及海馬旁回、左側(cè)頂上小葉、雙側(cè)島葉、枕葉及小腦,左側(cè)大腦半球激活腦區(qū)明顯多于右側(cè)大腦半球。維、漢正常人在執(zhí)行動(dòng)詞產(chǎn)生任務(wù)時(shí),維吾爾語(yǔ)組左側(cè)頂下小葉、左顳下回(BA37)、左側(cè)梭狀回和海馬旁回等局部腦區(qū)可見(jiàn)明顯的正激活,漢語(yǔ)組相對(duì)激活較弱；而漢語(yǔ)組右顳上回(BA38)可見(jiàn)明顯的正激活,維吾爾語(yǔ)組則相對(duì)激活較弱。結(jié)論：維吾爾語(yǔ)和漢語(yǔ)的語(yǔ)義辨別、動(dòng)詞產(chǎn)生激活腦區(qū)不完全相同。左側(cè)扣帶回在維吾爾語(yǔ)語(yǔ)義加工中可能更多參與語(yǔ)音加工。漢字加工處理可能比維文加工有更多的右半球參與。
[Abstract]:Part one: standardization of Uyghur aphasia examination.
Objective: the Uygur aphasia examination method is the translation of Chinese aphasia. According to the habits and rules of Uygur language and sentence, it is suitable for Uygur language environment and can be used in the assessment of diagnosis and treatment evaluation of Uygur aphasia. This part mainly studies Uygur aphasia examination. The reliability and validity of the law. Methods: to translate Gao Surong's Chinese aphasia examination into Uygur language. According to the characteristics of Uygur language, appropriate changes (such as retelling, hearing recognition and writing) are made, but the overall structure is unchanged. 3 rounds of evaluation and revision of the Uygur aphasia examination method are carried out by the method of expert review. The language function of 134 Uygur normal people and 104 Uygur post apoplexy aphasia patients was tested, and the language function assessment was assessed by 1 trained Uygur people when the patients were admitted to the hospital, and 30 of them were repeated one week later. Evaluation of language function. Summary data using factor analysis, Spearman rank correlation analysis and other methods to test the structural validity, intrinsic reliability, retest reliability and half reliability of Uygur aphasia examination method. Results: the difference rate between Chinese aphasia and Chinese aphasia was less than 10%. structure validity after Uygur retranslation: KMO value was 0.917, Bartlett ball The P value of form test is less than 0.005, indicating suitable factor analysis, using principal component analysis and maximum variance orthogonal rotation, extracting common factors according to 3 factors, named reading factor, writing factor, listening comprehension factor, and explaining the variance of 81.03%. Intrinsic reliability: the 24 aspects of the content of the scale are divided into four parts, oral expression and listening. The Cronbach alpha of each part was calculated as 0.969,0.922,0.966,0.924, and the total Cronbach alpha coefficient was 0.978. retest reliability, respectively. The correlation coefficient of the other 22 items in the other 22 items of the scale was greater than that of the 0.8. Uygur language loss detection scale, and the semi confidence of the other 22 items was 0.906. conclusion: 0.906. conclusion: This study suggests that Uygur aphasia examination has good validity and reliability. It can diagnose and classify Uygur aphasia and quantitatively reflect the language function of Uygur aphasia patients, which is suitable for clinical rehabilitation.
The second part is about the ill language characteristics of Uygur aphasia.
Objective: through systematic observation and evaluation of Uygur aphasia cases, the pathological language characteristics of Uygur aphasia were systematically analyzed by using neuropsychological methods, and compared with Chinese aphasia, the difference between the two pathological language characteristics was analyzed, and the preliminary analysis of various Uygur aphasia and aphasia The relationship between the type of writing disorder and the site of brain damage provides a theoretical basis for the diagnosis and rehabilitation of clinical Uygur aphasia. Methods: 104 Uygur post-stroke aphasia patients were assessed by the Uygur aphasia examination, and 81 cases of Chinese aphasia were evaluated by Chinese language loss examination. Traditional neuropsychological methods were used to analyze the results of listening, speaking, reading and writing, and comparing the differences between the two. Results: (1) sports aphasia was characterized by non fluency aphasia, telegraph, substance, phonetic disorder, understanding, rehearsal, reading and writing. Sports aphasia is similar to sports aphasia as a whole, but rehearsal. (2) sensory aphasia is characterized by fluent aphasia, more miswords and neologisms, serious disorders, rehearsal, naming, reading and writing disorders. Cortical sensory aphasia is similar to sensorimotor and rehearsal. (3) a mixed aphasia can be seen. The coexistence of cortical motor aphasia and cortical sensory aphasia, non fluent aphasia, the wrong language is more obvious, the hearing understanding is heavy, but less than sensory aphasia, the rehearsal function is retained, but incomplete. (4) named aphasia is fluent aphasia, serious nomenclature, understanding, rehearsal, reading, and writing disorder. (5) completeness All the language functions of the aphasia are severely damaged. Most patients can only make stereotyped monosyllabic words or words and only understand 1-2 simple instructions. (6) basal ganglia aphasia is mostly mild to moderate oral fluency disorder, slow speech effort, lack of coherence between words and words, dysarthria, understanding of mild disorders, rehearsal normal, moderate reading and writing. (7) thalamic aphasia is characterized by hypothalamic aphasia, low tone, reduced language, difficulty finding, moderate dysarthria, naming and understanding of mild disorders, and retelling normal. The verbal dominance of Uygur people is in the left hemisphere like the Han people, and 62.5% of the aphasia is caused by the classical language central lesions, with athletic aphasia, and the end of the language. Total aphasia and cortical mixed aphasia are more consistent. The type of dyslexia after Uygur aphasia is basically the same as that in Chinese, including two major categories of language disorder and nonverbal writing disorder. The two groups of Uygur, Han and Han are more common in aphasia and are more widely distributed in the lesion, and the loss of use in the Uygur language group is involved in the left top. The lotion of the left frontal lobe and the deep white matter in the left frontal lobe and its deep part are scattered in the left forehead, the parietal lobe and the basal ganglia. Conclusion: the pathological language characteristics of all types of Uygur aphasia are different, but the same type of Uygur language in Uygur language is basically the same. Different types of Uygur language disorders are different. There are different characteristics of pathological writing, but the same type of Uygur language, the pathological writing characteristics of Chinese writing disorders are basically the same. The language dominance hemisphere of Uygur people in the left hemisphere is the same as that of Han people; all types of Uygur aphasia, the type of post aphasia writing disorder has a certain relationship with the brain injury.
The third part: fMRI study on the difference of brain activation region between Uygur and Han normal people.
Objective: to use the BOLD technology in fMRI and to explore the brain function area of the normal people of our language with two language tasks, and to compare the brain activation differences between the normal people of the Han Dynasty and the two language tasks. Methods: 30 healthy volunteers were selected, 15 were Uygur, and 15 were Chinese, all were right hand. The function of the language is normal. Using the GE signa3.OT superconducting magnetic resonance imaging system of the United States company, the signal is received with the 8 channel head coil. First, the 3D thin layer scanning sequence is used to obtain the T1 weighted image of the craniocerebral transverse axis, and then the gradient echo plane imaging sequence is used to collect the data of the BOLD signal. Two language tasks were performed during the scanning process: semantic discrimination and verb generation, while the contrast was observed on the screen, "+" was displayed on the screen. The test task was completed by the method of silent reading. The post processing was performed with SPM5. The image analysis used SPM5 for individual analysis and group analysis. The statistical threshold was set to the correct p- < 0.05, and the voxel was more than 6. After the FDR correction, it was considered to be corrected. The differences were statistically significant. The data were statistically analyzed by single sample and double sample t test. Results: the activation brain areas of the Uygur normal people were mainly in the left middle frontal gyrus, the upper lobule, the lower occipital gyrus, the right occipital gyrus in different degrees of activation, the left cerebral hemisphere activated more brain regions than the right side. The difference of brain regions activated in the semantic discrimination task of the cerebral hemisphere. The normal people of the Han people is mainly in the left cingulate gyrus (BA23) and the front of the wedge. The Uygur language group shows significant positive activation in these two regions, while the Chinese group is relatively weak in the area, and the difference between the two is statistically significant. The normal Uygur verb generates the task to activate the brain area. Mainly for bilateral inferior frontal gyrus, middle frontal gyrus, anterior cingulate gyrus, auxiliary motor area, left basal ganglia, anterior central gyrus, left temporal gyrus, middle temporal gyrus, fusiform gyrus and paraphippocampal gyrus, left apical lobule, bilateral insula, occipital lobe and cerebellum, left cerebral hemisphere more active than right cerebral hemisphere. The left apical lobule, left temporal gyrus (BA37), left fusiform gyrus and parahippocampal gyrus were visible positive activation in the Uygur language group, while the relative activation of the Chinese group was weaker, while the right temporal gyrus (BA38) in the Chinese group was obviously positive and the Uygur language group was relatively weak. Conclusion: Uygur and Chinese Semantic discrimination shows that the active brain regions are not exactly the same. The left cingulate gyrus may be more involved in speech processing in Uygur semantic processing. The processing of Chinese characters may be more involved in the right hemisphere than the processing of the Uygur language.
【學(xué)位授予單位】：新疆醫(yī)科大學(xué)
【學(xué)位級(jí)別】：博士
【學(xué)位授予年份】：2013
【分類號(hào)】：R749.13

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 何雅娜;張權(quán);張?jiān)仆?宋明;朱曉冬;陳靜;伊慧明;蔣田仔;;腦梗死后運(yùn)動(dòng)性失語(yǔ)患者語(yǔ)言中樞的fMRI評(píng)價(jià)[J];磁共振成像;2010年01期

2 陳卓銘;臨床漢語(yǔ)失語(yǔ)癥診療新進(jìn)展[J];廣東醫(yī)學(xué);2004年11期

3 李科;金真;張磊;曾亞偉;張小峰;吳樵;;腦卒中后運(yùn)動(dòng)性失語(yǔ)的功能磁共振成像研究[J];中國(guó)臨床醫(yī)學(xué)影像雜志;2012年03期

4 蔣震;張彩元;貢志剛;蔡武;沈鈞康;;兩種語(yǔ)言任務(wù)腦功能區(qū)激活的功能磁共振成像比較[J];蘇州大學(xué)學(xué)報(bào)(醫(yī)學(xué)版);2008年03期

5 吳毅,胡永善,范文可,楊曉冰,王倩;康復(fù)醫(yī)學(xué)功能評(píng)定量表信度和效度研究[J];中國(guó)臨床康復(fù);2002年03期

6 楊振燕,趙小虎,戴工華;中英文語(yǔ)言活動(dòng)區(qū)功能磁共振成像研究[J];中國(guó)臨床康復(fù);2003年10期

7 劉樹(shù)永;李敏;耿道穎;;急性期腦梗死引起的運(yùn)動(dòng)性失語(yǔ)的功能磁共振研究[J];醫(yī)學(xué)影像學(xué)雜志;2010年11期

8 陳卓銘,凌衛(wèi)新,黃偉新,莫雷,蔣耀宇,羅東媚;語(yǔ)言障礙診治儀ZM2.1的診斷設(shè)計(jì)[J];中華物理醫(yī)學(xué)與康復(fù)雜志;2005年09期

9 張小寧;鄒梅;吐?tīng)栠d;郝晨光;馬建華;蔡堅(jiān);韓登峰;彭成星;;新疆維吾爾族和漢族急性腦卒中患者臨床特點(diǎn)分析[J];中華腦血管病雜志(電子版);2009年04期

10 李勝利,肖蘭,田鴻,衛(wèi)冬潔,秦江天,馮定香,賈革紅,陳巍,何怡,張慶蘇,李錚,朱麗君,丘衛(wèi)紅,吳卓華,王全兵,朱秀風(fēng),雷兵,王娟,朱燕平,王翠萍,陸敏;漢語(yǔ)標(biāo)準(zhǔn)失語(yǔ)癥檢查法的編制與常模[J];中國(guó)康復(fù)理論與實(shí)踐;2000年04期

本文編號(hào)：1915160