蒙特利尔认知功能评估量表和事件相关电位在血管性认知功能障碍中的应用比较  

Comparison of Montreal Cognitive Assessment Scale and event-related potentials in vascular cognitive impairment

作　　者：史欣[1] 韩颖[1] 刘青蕊[1] 刘名顺[1] 李真[1] 周庆茹[1] 

机构地区：[1]河北医科大学第四医院神经内科,河北石家庄050011

出　　处：《临床荟萃》2011年第12期1040-1044,共5页Clinical Focus

基　　金：河北省卫生厅医学科学研究重点课题(20100422)

摘　　要：目的探讨蒙特利尔认知功能评估量表(MoCA,中文版)和事件相关电位-P300在血管性认知功能障碍中的应用比较。方法将137例脑血管病患者进行简易精神状态检查量表(MMSE)测试后分为无认知功能障碍(NCI)组、无痴呆的轻度血管性认知功能障碍(VCIND)组和血管性痴呆(VD)组,分别进行P300和MoCA测试。结果①随认知障碍程度的加深,MoCA评分逐渐降低,P300潜伏期延长,波幅降低(P<0.01)。②在诊断VD中,以MMSE为金标准,MoCA敏感度较高(敏感度100%,特异度54.0%,准确度70.8%),P300潜伏期与其类似(敏感度100%,特异度58.6%,准确度73.7%);P300波幅采取两种分界值,敏感度分别为82.0%和44.0%,特异度80.5%和97.7%,准确度81.0%和78.1%。结论 MoCA及P300均随认知障碍程度而改变,可作为认知障碍的监测指标;MoCA和P300潜伏期对轻度血管性认知功能障碍更敏感;P300波幅敏感度低,不能作为判断血管性认知功能障碍认知功能的依据。Objective To compare Montreal Cognitive Assessment Scale（MoCA）（Chinese version） and event-related potential-P300 in vascular cognitive impairment.Methods 137 patients with cerebrovascular diseases tested by MMSE were divided into non-cognitive impairment（NCI） group,vascular cognitive impairment no dementia（VCIND） group and vascular dementia（VD） group.All the three groups were tested by event-related potentials-P300 and MoCA.Results ①With the progress of cognitive impairment,MoCA score gradually decreased,latency of P300 extended and amplitude decreased.②In the diagnosis of VD,with MMSE as the gold standard,MoCA had higher sensitivity（sensitivity 100%,specificity 54.0%,accuracy 70.8%）,P300-latency was similar with it（sensitivity 100%,specificity 58.6%,accuracy 73.7%）,P300-amplitude adopted two boundary values（sensitivity 82.0% and 44.0%,specificity 80.46% and 97.7%,accuracy 81.0% and 78.1%）.Conclusion P300 and MoCA change with the degree of cognitive impairment can be detected as indicators of cognitive impairment;MoCA and P300-latency for mild vascular cognitive impairment are more sensitive,and because of low sensitivity,P300-amplitude can not serve as cognitive function diagnosis of vascular cognitive impairment.

关 键 词：认知障碍 心理学试验 脑电描记术 

分 类 号：R743[医药卫生—神经病学与精神病学]