Article(id=1322168297282454456, tenantId=1146029695717560320, journalId=1220038315760373764, issueId=1322168262247432815, articleNumber=null, orderNo=null, doi=10.12102/j.issn.1009-6493.2026.05.020, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1744214400000, receivedDateStr=2025-04-10, revisedDate=1763308800000, revisedDateStr=2025-11-17, acceptedDate=null, acceptedDateStr=null, onlineDate=1793159086770, onlineDateStr=2026-10-28, pubDate=1773072000000, pubDateStr=2026-03-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793159086770, onlineIssueDateStr=2026-10-28, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793159086770, creator=13701087609, updateTime=1793159086770, updator=13701087609, issue=Issue{id=1322168262247432815, tenantId=1146029695717560320, journalId=1220038315760373764, year='2026', volume='40', issue='5', pageStart='705', pageEnd='880', issueExtLink='null', onlineDate='null', pubDate='1773072000000', pubDateStr='2026-03-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1793159078418, creator='13701087609', updateTime=1793159078418, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext=null, issueFiles=null, downloadFileDto=null}, startPage=848, endPage=852, ext={EN=ArticleExt(id=1322168297513141177, articleId=1322168297282454456, tenantId=1146029695717560320, journalId=1220038315760373764, language=EN, title=Application progress on intelligent screening tools based on speech technology in mild cognitive impairment patients, columnId=1220689485315101342, journalTitle=Chinese Nursing Research, columnName=Review Articles, runingTitle=null, highlight=null, articleAbstract=

This article summarized the language characteristics of individuals with mild cognitive impairment and speech analysis technologies.It introduced intelligent speech screening tools used both domestically and internationally,and discussed existing challenges along with proposed suggestions.The aim was to provide a foundation for the development of intelligent speech technology-based screening tools for mild cognitive impairment in China.

, authors=Mihui FU1, Hui HU1, 2, Yating AI1, 2, Pengjun ZHOU1, Xiaotong WANG1, Shuo WANG1, Zhangxin LIN1, authorsList=Mihui FU, Hui HU, Yating AI, Pengjun ZHOU, Xiaotong WANG, Shuo WANG, Zhangxin LIN, authorCompany=null, correspAuthors=Hui HU, authorNote=null, correspAuthorsNote=
HU Hui, E-mail:
, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1322168297840296890, articleId=1322168297282454456, tenantId=1146029695717560320, journalId=1220038315760373764, language=CN, title=基于语音技术的智能化筛查工具在轻度认知障碍病人中的应用进展, columnId=1220689485482873504, journalTitle=护理研究, columnName=科研综述, runingTitle=null, highlight=null, articleAbstract=

总结轻度认知障碍人群的语言特点和语音分析技术,介绍国内外智能化语音筛查工具,提出现存问题及建议,以期为我国开发基于智能化语音技术的轻度认知障碍筛查工具提供依据。

, authors=符敉晖1, 胡慧1, 2, *, *, 艾亚婷1, 2, 周芃君1, 汪小彤1, 王硕1, 林章新1, authorsList=符敉晖, 胡慧, 艾亚婷, 周芃君, 汪小彤, 王硕, 林章新, authorCompany=null, correspAuthors=胡慧, authorNote=

符敉晖,硕士研究生在读

, correspAuthorsNote=
胡慧,E-mail:
HU Hui, E-mail:
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remark=2湖北时珍实验室)])], figs=[ArticleFig(id=1322530210239599274, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168297282454456, language=EN, label=Table 1, caption=

Summary of intelligent speech screening tools for MCI

, figureFileSmall=null, figureFileBig=null, tableContent=
筛查工具准确率(%)筛查用时(min)使用方式适用范围
SCS79.306.0小程序适用于中国社区老年人的早期认知障碍筛查、临床认知评估、远程自我评估
DCS75.605.9机器人对话适用于中国社区老年人的早期认知筛查,需要快速、大规模筛查的场景,能有效识别方言
CognoSpeak83.3030.0电脑、平板适用于英语使用人群的远程认知评估,适用于多场景
Smartwatch和Smartphone79.105.0智能穿戴设备适用于拥有智能手表和智能手机的用户、认知障碍的远程评估和高频评估
), ArticleFig(id=1322530210306708139, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168297282454456, language=CN, label=表1, caption=

MCI语音智能化筛查工具总结

, figureFileSmall=null, figureFileBig=null, tableContent=
筛查工具准确率(%)筛查用时(min)使用方式适用范围
SCS79.306.0小程序适用于中国社区老年人的早期认知障碍筛查、临床认知评估、远程自我评估
DCS75.605.9机器人对话适用于中国社区老年人的早期认知筛查,需要快速、大规模筛查的场景,能有效识别方言
CognoSpeak83.3030.0电脑、平板适用于英语使用人群的远程认知评估,适用于多场景
Smartwatch和Smartphone79.105.0智能穿戴设备适用于拥有智能手表和智能手机的用户、认知障碍的远程评估和高频评估
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基于语音技术的智能化筛查工具在轻度认知障碍病人中的应用进展
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符敉晖 1 , 胡慧 1, 2, *, * , 艾亚婷 1, 2 , 周芃君 1 , 汪小彤 1 , 王硕 1 , 林章新 1
护理研究 | 科研综述 2026,40(5): 848-852
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护理研究 |科研综述 2026 , 40 (5) : 848 -852
基于语音技术的智能化筛查工具在轻度认知障碍病人中的应用进展
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符敉晖1, 胡慧1, 2, *, * , 艾亚婷1, 2, 周芃君1, 汪小彤1, 王硕1, 林章新1
作者信息
  • 1湖北中医药大学护理学院,湖北 430065
  • 2湖北时珍实验室
通讯作者:
胡慧,E-mail:
HU Hui, E-mail:
作者简介:

符敉晖,硕士研究生在读

Application progress on intelligent screening tools based on speech technology in mild cognitive impairment patients
Mihui FU1, Hui HU1, 2 , Yating AI1, 2, Pengjun ZHOU1, Xiaotong WANG1, Shuo WANG1, Zhangxin LIN1
Affiliations
  • 1School of Nursing, Hubei University of Chinese Medicine, Hubei 430065 China
  • 2Hubei Shizhen Laboratory
  • Corresponding Author:
    HU Hui, E-mail:
出版时间: 2026-03-10 doi: 10.12102/j.issn.1009-6493.2026.05.020
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总结轻度认知障碍人群的语言特点和语音分析技术,介绍国内外智能化语音筛查工具,提出现存问题及建议,以期为我国开发基于智能化语音技术的轻度认知障碍筛查工具提供依据。

认知障碍  /  语音分析  /  语音识别  /  智能化  /  筛查工具  /  综述

This article summarized the language characteristics of individuals with mild cognitive impairment and speech analysis technologies.It introduced intelligent speech screening tools used both domestically and internationally,and discussed existing challenges along with proposed suggestions.The aim was to provide a foundation for the development of intelligent speech technology-based screening tools for mild cognitive impairment in China.

cognitive impairment  /  speech analysis  /  speech recognition  /  intelligentization  /  screening tools  /  review
符敉晖, 胡慧, 艾亚婷, 周芃君, 汪小彤, 王硕, 林章新. 基于语音技术的智能化筛查工具在轻度认知障碍病人中的应用进展. 护理研究, 2026 , 40 (5) : 848 -852 . DOI: 10.12102/j.issn.1009-6493.2026.05.020
Mihui FU, Hui HU, Yating AI, Pengjun ZHOU, Xiaotong WANG, Shuo WANG, Zhangxin LIN. Application progress on intelligent screening tools based on speech technology in mild cognitive impairment patients[J]. Chinese Nursing Research, 2026 , 40 (5) : 848 -852 . DOI: 10.12102/j.issn.1009-6493.2026.05.020
随着全球人口老龄化的加剧,认知障碍成为日益严重的公共健康问题。轻度认知障碍(mild cognitive impairment,MCI)是一种由于大脑皮层功能和结构异常,使病人在语言、记忆、执行、注意、计算和定向力等方面出现不同程度损伤的精神类疾病,是人类正常衰老和痴呆之间的临床阶段[1]。流行病学调查指出,全球50岁及以上社区居民中MCI的患病率为13.24%~18.03%[2],其中80%的MCI病人会转化为痴呆,远高于正常老年人1%~2%的发病率[3]。《应对老年期痴呆国家行动计划(2024—2030年)》指出,要开展老年痴呆早期筛查与干预,积极推动互联网、大数据、人工智能等在老年期痴呆防控中的应用。因此,使用客观、准确的筛查工具早期识别并干预MCI对痴呆的防治意义重大,可有效控制甚至逆转认知损伤[4-5]。MCI的诊断方法(如神经心理测试)往往依赖病人的配合和专业医师的判断,且耗时长,在早期诊断时容易导致拒访率高、漏诊率高、检出率低[6];神经影像学和生物标志物检测虽然具有较高的敏感性和特异性[7-9],但操作复杂、具有侵入性、成本高昂,难以普及。语音作为一种重要的生理信号,能够反映个体的大脑功能状态,尤其是与语言处理相关的认知功能。当大脑的认知功能受到损害时,病人的语音特征往往会出现细微的变化,如语速减慢、语调平淡、发音不清晰等[10],这些变化常常是认知受损的早期信号,且语音数据的采集成本低、便捷,具有广泛的应用潜力。因此,现对基于语音技术的智能化筛查工具在识别MCI人群中的应用进行综述,以期为MCI人群的信息化筛查工具的发展和推广提供参考。
虽然内侧颞叶损伤导致的记忆障碍是MCI的典型症状,但语言问题也很普遍。神经影像学证据表明,双侧前颞叶被认为是语义网络的核心区[11]。MCI病人通常因大脑皮层的萎缩,与语言相关的脑区受损,进而出现语言障碍[12-13]。Huang等[14]在一项对于404例MCI病人的队列研究发现,孤立性语言障碍的MCI病人表现出颞-前额-顶叶区域的低连接性。这一低连接性模式可作为孤立性语言障碍的生物标志物,帮助早期诊断MCI,特别是在仅有语言症状而缺乏其他显著认知受损症状的情况下。MCI病人的语言特点是多维度的,涵盖了发音、命名、语法、音韵学以及高级语言功能等多个方面。病人早期以语义记忆障碍为突出症状,病人出现不能命名和找词困难等[15],会用通用术语代替更加具体的术语,且对于动词的命名相较于名词更加困难。此外,停顿、重复、语言流畅性下降、语序错乱、句子结构不完整等在MCI早期也很明显[10]。他们在理解复杂句子、长篇对话或抽象概念时也会遇到困难,不理解幽默、讽刺或其他社会性语言行为,可能在社交互动中出现用语障碍[16-17]。随着对MCI病人语言特征的研究深入,越来越多的证据表明,声学特征在区分MCI与健康人群中的应用具有重要潜力。Yamada等[18]通过提取语音速率、停顿比例、声音频率和幅度等韵律和声学特征,用于区分阿尔茨海默病(Alzheimer's disease,AD)和路易体痴呆(dementia with Lewy body,DLB),准确率为87.4%。Wang等[13]对来自中国多中心队列的324名受试者的语言停顿时间百分比(percentage of silence duration,PSD)进行分析,发现与健康老年人相比,PSD在遗忘型轻度认知障碍(amnestic mild cognitive impairment,aMCI)和AD病人中均显著增加,且认知障碍受试者右侧额下回三角部的激活水平与PSD呈现正相关。这些研究为语言生物标志物在认知障碍的早期筛查、诊断提供了依据。
在基于语音技术的智能化筛查工具中,识别认知障碍的核心在于从语音信号中提取出与认知功能变化相关的特征,通过深入的分析模型来判断病人是否存在认知障碍。首先,语音信息的获取包括数据库和研究者根据研究需求自行获取的语音数据。Dementia Bank是最常用的认知障碍开源数据库之一,包含英语、汉语、德语、西班牙语的老年人语义流利性任务、看图说话、故事叙述等语料。David等[19]使用Dementia Bank数据库中552个样本的语音和转录文本,开发了语音和文本特征相结合的多模态预测模型,该模型最终识别AD和健康人群的准确率为81.92%。其次,MCI病人的语音特征在多个维度上与健康人群存在差异,这些特征能够通过语音识别技术(automatic speech recognition,ASR)和自然语言处理技术(natural language processing,NLP)准确捕捉到,且机器学习和深度学习相结合的方法成为老年人认知功能评估分析的主流方法[10],广泛应用于模型训练与分类。Amini等[20]使用ASR与NLP等先进技术,构建了机器学习预测工具,旨在精准识别处于MCI阶段且未来有较高风险发展为AD的病人。Mili等[21]使用Praat软件提取了老年人和年轻人的基频、共振峰、音强等音频信息并进行对比,结合机器学习算法进行语音可理解性评估,发现老年人的最大发声时间较短,句子阅读时的气流更大,基频、共振峰等声学特征的变异度较低。最后,通过将受试者的语音特征输入训练好的模型,系统能够快速输出受试者是否存在MCI风险的预测结果。
SCS是针对中国人群、基于语音识别的智能化认知评估工具,被推荐用于社区老年人早期认知障碍的快速筛查[22]。SCS是依据认知范式、基于机器学习算法、融合神经心理量表和语音标志物对认知功能进行多模态评估的计算机化认知评估工具(Computerized Neuropsychological Assessments Devices,CNADs)[23]。它设置了命名和即刻回忆、自由回忆、数字符号转换测验、延迟回忆以及再认5个板块,从而对感觉记忆、短时记忆、注意力、执行力、视知觉、语言和总体认知功能进行综合评估。用户通过语音和手指交互依次完成答题任务,用户音频将被实时传递至自动语音识别(ASR)服务器进行处理和识别。最终,通过整合测试数据会生成用户的测试分数(满分120分,分数越高表示认知功能越好)和语音特征的即时报告,全程花费约6 min[24]。Huang等[25]通过对社区老年人进行调查发现,SCS具有良好的诊断性能,其中对AD检测的敏感度为90.3%,特异度为94.5%;对MCI检测敏感度为79.3%,特异度为67.1%。有研究发现,在基于SCS调查与认知障碍相关的语言生物标志物的基础上,使用机器学习技术能更准确地检测早期认知障碍,准确率为95.3%,灵敏度为93.3%,特异度为93.3%[23]。与传统的纸质认知测评相比,SCS小程序更有效、经济,适用于中国老年人和其他阿尔茨海默病相关痴呆(Alzheimer's disease related dementia,ADRD)高危人群的临床认知评估、远程自我评估以及MCI、痴呆的社区筛查[26]。但目前关于SCS的研究样本量较小未来需要进行大样本量的临床试验进行验证。
DCS以传统认知测试为模板,通过机器人对话的方式,与测试者进行对话问答,并自动收集测试者的音频,随后通过ASR将收集到的音频转为文本,再进行自然语言理解(natural language understanding,NLU),最后,利用模型将文本与正确答案进行匹配,通过构建算法模型预估参与者的痴呆风险。DCS评分范围为0~12分(得分越高表示认知功能越好),认知测试项目包括记忆、定向力和执行功能[27]。同时,为了解决ASR在处理汉语方言等不标准发音方面的挑战,DCS开发了端对端的模型(multimodal understanding,MMU),这个模型无需转换文本,可直接从录音中识别关键信息,减少了中间错误和步骤,使其能够更有效地处理汉语方言。DCS是全球首个大规模基于语音识别和利用对话式人工智能的认知筛查工具,在中国社区老年人中具有良好的信度、有效性和可行性。Zhao等[28]通过对11 186名参与者进行DCS筛查,发现DCS的筛查完成率可高达97.5%;DCS诊断痴呆的灵敏度和特异度分别为90.0%和92.3%,诊断MCI的灵敏度和特异度分别为78.8%和74.2%,准确率为75.6%。DCS对不同年龄、性别、教育水平的痴呆和MCI病人均有很好的筛查效力;与蒙特利尔认知评估量表(MoCA)和简易精神状况检查量表(MMSE)相比,DCS可节约16.2%~36.0%的筛查时间,测试的筛查时间仅(5.9±0.8)min。但是,DCS不适合有严重听力或言语障碍的人群,且需要在中国的不同地区对说不同方言的老年人进行验证。
CognoSpeak是一个自动化、远程、低成本、可重复、非侵入性、低压力的工具,用于早期检测认知受损。CognoSpeak的数据收集规模是目前同类工具中最大的,通过在英国初级保健和二级保健机构以及Join Dementia Research等全国性网站进行远程招募,收集了大规模的真实世界的音频、视频和丰富的元数据,覆盖了不同健康状况和背景的参与者。迄今为止,CognoSpeak已有超过1 600名参与者完成了评估,且仍在持续招募。参与者可以通过网页浏览,在电脑或平板上选择4个虚拟代理之一,这些代理代表不同的种族和年龄群体。虚拟代理会与参与者进行对话,对话涉及记忆、语言和注意力的多个领域,如短期记忆、长期记忆、语义流畅性和图片描述任务等。当虚拟代理提示受试者在移动和网络等多个平台上执行一系列任务时,CognoSpeak会收集他们的音频和视频记录,提取参与者的声学特征和语言特征以训练和评估模型分类器。DistilBERT模型在整体性能上表现佳,预测健康对照组的准确率为92.1%,预测MCI的准确率为83.3%,预测痴呆的准确率为80.4%,检测痴呆或MCI的特异度为92.1%,敏感度为81.0%[29]。CognoSak的优势是自动化、远程化,能够在初级保健室、社区、家中通过平板或电脑远程管理,而不需要临床医生直接监督[30],减轻了初级保健的压力。但目前CognoSpeak主要基于英语对话,并且只对整个数据集中的126名参与者的子集进行了分析,样本规模小,花费时间较长。
智能设备在全球范围内的使用量达数十亿,这些智能设备的广泛普及为医学临床研究带来了巨大便利,为认知障碍的早期筛查和长期监测提供了新的视角。2019年,Cormack等[31]的研究采用Apple Watch应用程序对重度抑郁病人进行每天3次的n-back任务评估和每天1次的情绪评估,支持了使用可穿戴设备对重度抑郁症病人进行长期认知和情绪高频评估的可行性和有效性。2023年,Schalkamp等[32]结合10万人的数据发现,连续佩戴7 d医用级智能手表可以在帕金森病出现标志性症状前7年识别出帕金森病。2025年,Butler等[33]进一步探索了利用iPhone和Apple Watch的多模态数据进行认知筛查的前景。2万多名参与者佩戴Apple Watch,并通过智能手机进行交互式认知测量和被动数据测量;除了常规的交互认知测试,如剑桥神经心理测试自动化成套测验(CANTAB)评估和剑桥认知检查(Cam-Cog)评估外,参与者还需要完成每季度1次的语言评估,每次约5 min;被动测量方面,iPhone和Apple Watch的多模态数据可测量多种人体功能,Sensor Kit系统收集设备和应用使用、键盘指标、消息和电话使用等信息,Health Kit记录参与者的音高、抖动和震颤等声学特征和其他生理参数。研究结果显示,设备使用行为、键盘输入、语音特征等日常生活现象与认知表现之间存在一定的关联。结合智能手机和智能手表收集的信息能够有效区分认知功能正常者和MCI病人,敏感度、特异度、准确率分别为80.2%、78.7%、79.1%,阳性预测值、阴性预测值分别为55.6%、98.3%,展示了智能设备在认知障碍远程评估中的巨大潜力。但研究要求参与者必须能够流利使用英语并拥有iPhone,一定程度上限制了研究结果的普遍适用性。
目前,开源数据库的规模有限,大多数研究的样本量纳入较少,难以满足深度学习所需的庞大数据量,不同研究者采用的语音任务,如自由叙述、单词复述、图片描述等评估标准存在差异,进一步限制了数据的可复用性。因此,扩大数据库是未来发展的基础。
现有语音筛查工具的开发依赖单一语言体系,英语在数据库中占据主导地位,而针对汉语及其他语言使用者的研究较少。我国系统建设的老年人话语多模态语料库(multimodal corpus of gerontic discourse,MCGD)尚未实现数据共享[34]。此外,老年人常使用方言或混合语言交流,现有工具难以适应这种多样性。不同语言的语法、词汇和发音模式差异显著,直接迁移模型可能导致性能下降。因此,对病人的语言特征进行更加全面、细致地提取与分析,探索通用的语言标志物是重点研究方向。
尽管基于语音特征的MCI筛查在理论研究上已取得较高的准确率,但大多数研究停留在实验室环境下的模型构建阶段,缺乏真实场景验证,如家庭、社区或医院嘈杂环境下的鲁棒性测试。因此,需要深入探索这些局限性的本质,推动语音筛查技术从实验室走向临床应用。
语音特征在MCI早期筛查中具有显著潜力,通过分析语言和声学特征,结合机器学习和深度学习技术,能够有效区分MCI病人与健康人群。多种语音筛查工具如SCS、DCS、CognoSpeak、智能穿戴设备等已初步展现出良好的诊断性能,为MCI的快速、低成本筛查提供了可能。然而,当前研究仍面临数据规模有限、语言体系单一、转化应用不足等问题,限制了其广泛应用。未来需进一步扩大多语音数据库,加强语言生物标志物的探索,加强真实场景下的应用验证,推动语音筛查技术走向临床实践,从而更好地实现MCI的早期识别与干预,为应对全球人口老龄化带来的认知障碍挑战提供有力支持。

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2026年第40卷第5期
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doi: 10.12102/j.issn.1009-6493.2026.05.020
  • 接收时间:2025-04-10
  • 首发时间:2026-10-28
  • 出版时间:2026-03-10
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  • 收稿日期:2025-04-10
  • 修回日期:2025-11-17
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    1湖北中医药大学护理学院,湖北 430065
    2湖北时珍实验室

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胡慧,E-mail:
HU Hui, E-mail:
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2种不同金属材料的力学参数
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genus
种数
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species
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total species (%)
属
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种数
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species
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species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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