中文摘要：

目的：应用汉语失语症心理语言评价（PACA）是否可以明确脑卒中后听理解障碍产生于听觉言语输入加工的某个水平,通过复测是否可预测听理解能力恢复的可能。方法：对1例听理解严重损害伴杂乱语,左颞顶叶、右颞叶脑梗死患者发病后2周和5周分别进行汉语失语症心理语言评价相关检查。结果：患者发病2周后的听觉词-图匹配正确率17.5%,视觉词-图匹配正确率90.0%,看图-书写正确率67.5%,看图命名正确率47.5%,词复述2.5%。听理解与阅读理解测验结果存在明显差异（P〈0.01）,提示语义保留较好,而听觉语音映射到语义表征之前的加工受损。因此对听觉输入的语音分析进行了进一步检查,包括环境声音识别、语音识别、最小差异听字-指图均受损,语音识别、最小差异听字-指图受损更为严重。诊断感觉性失语症。第2次语言评价结果显示：视觉词-图匹配完全恢复正常,看图书写改善,听觉词-图匹配略有改善,词复述、环境声音识别、语音识别、最小差异听字指图未见改变。结果提示语音听感知受损,导致后续的听觉词汇加工不能进行,而语义系统正常。复测结果显示语音加工无改变,提示听理解预后较差,而影响听理解恢复的是语音识别。结论：汉语失语症心理语言评价可以较好地揭示听理解损害的加工水平,通过复测可提供语言功能预后,并使失语症的语言治疗更有针对性。

英文摘要：

Objective： To identify which level of auditory processing is impaired in an aphasic patient with severe auditory word comprehension difficulty after stroke using psycholinguistic assessment in Chinese aphasia （PACA）, and to predict the possibility of improvement in auditory comprehension through re-test. Method： A female aphasic patient with severe auditory comprehension impairment, and jargon speech was examined and re-examined with PACA 2 and 5 weeks after stroke. Result： The patient′s first exam showed 17.5% correct response rate in spoken word-picture matching, 90.0% in written word-picture matching, 67.5% in picture name writing, 47.5% in oral picture naming, and 2.5% in word repetition. There was a significant difference between spoken and written word-picture matching （P0.05）, indicating preserved semantics and an impairment before sound mapping onto semantic representation. Therefore, auditory input processing function was examined further, including environmental sounds identification, phoneme discrimination, spoken word-picture matching with minimal differences. All of these tests showed impaired abilities, especially in phoneme discrimination, and spoken word-picture matching with minimal differences. The patient was diagnosed as Wernicke′ s aphasia. In the second exam, there was complete recovery in written word-picture matching, and improvement in picture name writing （P0.05）, but no change was found in environmental sounds identification, phoneme discrimination, spoken word-picture matching with minimal differences. These results suggested that phonologic analysis was badly damaged, resulted in the following processing could not be conducted. However, semantic system was normal, proved by impact of written word-picture matching. No change found in phonologic processing in re-exam compared with the first one indicates poor prognosis for auditory comprehension. Conclusion： PACA can well identify the impaired level of auditory comprehension disorder for Chinese aphasics, and pre