蒙特利尔认知评估量表在癫认知功能障碍患者中的应用价值  

Evaluation of Montreal Cognitive Assessment in Epilepsy Patients with Cognitive Impairment

作　　者：韩健[1] 尹琪华[1] 

机构地区：[1]浙江省绍兴市第六人民医院老年科,312000

出　　处：《中国临床神经科学》2013年第1期75-80,共6页Chinese Journal of Clinical Neurosciences

摘　　要：目的分析蒙特利尔认知评估（MoCA）量表筛查癫痫患者认知功能障碍的应用价值。方法使用简明精神状态检查（MMSE）量表筛查出认知功能正常的120例癫痫患者，再行MoCA量表评分。依据MoCA量表评分结果将120例癫痫患者分为①认知功能正常（NC）组：MoCA量表评分≥26分；②认知功能损害（CI）组：MoCA量表评分〈26分。比较两组癫痫患者MoCA量表各项分数的差异及认知功能改变的特点，应用单因素及多元Logistic回归分析认知功能损害的影响因素。结果①120例患者中50例（41．7％）MoCA量表评分〈26分；②CI组MoCA量表各条目得分均低于NC组，差异有统计学意义（p〈0．05）；③Logistic回归分析结果显示，受教育年限是认知功能损害的影响因素（OR=1．34，95％CI：1．05～1．70，P〈0．05）。结论MMSE正常癫痫患者中仍存在相当比例MoCA量表评分异常的患者。建议使用MoCA量表测试癫痫患者的认知功能水平。Aim To evaluate the application of Montreal Cognitive Assessment（MoCA） in epilepsy patients with cognitive impairment. Methods Epilepsy patients with normal cognition were examined by Mini-Mental State Examination （MMSE）, whose MMSE scores were included in the further study of MoCA testing. The patients with MoCA score not less than 26 were selected into normal control （NC） group, and the patients with less than 26 into cognitive impaired （CI） group. MoCA scores in CI group being used as dependent variable, gender, educational level, age, course of disease, Hamilton Depression Rating Scale（HAMD）, Hamilton Anxiety Rating Scale（HAMA）, Self-rating Depression Scale（SDS）, Self-rating Anxiety Scale（SAS） were used as independent variable. And the risk Scale（HAMD）, HAMA, SDS, SAS were used as independent variable. The risk factors of CI in epilepsy patients was analyzed by Logistic linear regression analysis. Results There are 41.7% （50/120） epilepsy patients with MMSE less than 26 while their MoCA not less than 26. There were significant differences between CI group and NC group in subtests ofMoCA. Univariate and multivariate regression analysis showed that educational level was the most significant factor in CI（OR=1.34, 95% CI： 1.05-1.70, P〈0.05）. Conclusion There was a high proportion of epilepsy patients whose MMSE testshowed normal but MoCA test showed cognitive impairment. Therefore, it was recommended that the cognitive level of epilepsy patients should be used by MoCA clinically.

关 键 词：帕金森病 认知功能障碍 蒙特利尔认知评估量表 

分 类 号：R742.1[医药卫生—神经病学与精神病学]