蒙特利尔评估表筛查皮质下非痴呆血管性认知障碍的研究  

Feasibility study of the Montreal Cognitive Assessment for screening subcortical vascular cognitive impairment-no dementia

作　　者：王益[1] 陈绪才[1] 朱迎春[1] 王国成[1] 周捷[1] 

机构地区：[1]江苏省句容市人民医院神经内科,212400

出　　处：《中国临床研究》2012年第12期1158-1160,共3页Chinese Journal of Clinical Research

基　　金：镇江市科技支撑计划(20112202)

摘　　要：目的探索蒙特利尔认知评估量表(MoCA)筛查汉族老年人皮质下非痴呆血管性认知障碍(VaCIND-S)的可行性。方法对诊断为VaCIND-S的38例汉族老年人进行MoCA、简易精神状态量表(MMSE)等检查,设定简易精神状态量表(MMSE)<27分或MoCA<26分为认知功能障碍。计算Z分值用来评价个体间MMSE和MoCA各亚组的鉴别能力。结果虽然MMSE和MoCA存在良好的正相关(r=0.708;P<0.01),但在15例MMSE评分正常者中有13例(86.67%)存在MoCA评分异常,有5个MMSE亚组(定向力、注意计算、即刻记忆、命名、语言功能)的Z分值>4分(分别为7.28、5.57、5.89、5.50、4.49分),而MoCA仅有定向力一个亚组Z分值>4分(12.41分)。结论本研究发现MoCA是一个可靠的VaCIND-S筛选工具,且较MMSE敏感,但尚需要在大规模人群及不同种族人群中进行研究。Objective To explore feasibility of the Montreal Cognitive Assessment（MoCA） for screening subcortical vascular cognitive impairment-no dementia（VaCIND-S） in an elderly Han population.Methods The detections of MoCA,mini-mental state examination（MMSE）,etc.were performed in 38 patients diagnosed as having VaCIND-S,and the judging criteria for cognitive impairment were enacted as score27 for MMSE or score26 for MoCA.Z-scores were calculated to evaluate the discriminating ability of individual among MMSE and MoCA subgroups scores.Results Although there was a strong positive correlation between the total MMSE and total MoCA scores（r=0.708,P0.01）,yet of the 15 patients with normal scores for MMSE,13（86.67%） had impaired MoCA scores,and of 5 MMSE subgroups having Z-scores4[（orientation（7.28）,attention/calculation（5.57）,registration（5.89）,naming（5.50）,language（4.49）],1 MoCA subgroup（orientation）had the Z-score4 only（12.41）.Conclusion This study shows that MoCA is a reliable screening instrument for VaCIND-S,and its sensitivity is superior to MMSE,but further investigation should be performed in large sample-size and different ethnic population.

关 键 词：皮质下非痴呆血管性认知障碍 蒙特利尔认知评估表 简易精神状态量表 筛查 

分 类 号：R749.13[医药卫生—神经病学与精神病学]