无症状性颈动脉狭窄患者认知功能障碍的特点  

Characteristics of cognitive impairment in patients with asymptmatic carotid stenosis

作　　者：王世芳[1] 黄小琼[1] 吴志强[1] 丘东海[1] 李润雄[1] 罗根培[1] 肖卫民[1] 

机构地区：[1]东莞市人民医院神经内科,广东523000

出　　处：《中国脑血管病杂志》2013年第12期649-652,共4页Chinese Journal of Cerebrovascular Diseases

基　　金：东莞市科技局科研基金资助项目(201210515001090)

摘　　要：目的探讨蒙特利尔认知评估量表（MoCA）在无症状性颈动脉狭窄（ACS）患者中筛查认知功能障碍者的作用及ACS认知功能障碍的神经心理学特点。方法前瞻性连续纳入72例符合研究标准的患者，按CT血管造影（CTA）显示颈动脉狭窄程度（〉150％或〈50％）分为ACS组和对照组各36例，采用MoCA和简易精神状态量表（MMSE）对患者进行认知评估。比较两组MoCA总分、各子项目评分和MMSE评分。结果①两组基线学特征和血管性危险因素差异无统计学意义（均P〉0．05）。ACS组采用MoCA法检测认知功能障碍的阳性率（80．6％）高于MMSE法（13．9％），差异有统计学意义（P〈0．叭），对照组采用MoCA法检测认知功能障碍的阳性率（38．9％）高于MMSE法（5．6％），差异有统计学意义（P〈0．01）。②ACS组MoCA总分中位数低于对照组[21．5（10－29）和25（14～28），P=0．001]。ACS组与对照组各子项目评分显示，执行能力[0（0～1）和1（0～1），P：0．004]、视空间功能[3（0－4）和3．5（0～4），P=0．004]、注意力[5（2～6）和6（4～6），P=0．001]、延迟回忆[2（0～5）和3（0～5），P=0．038]，差异均有统计学意义。结论MoCA比MMSE可更灵敏地检测出无痴呆ACS患者的认知功能障碍。以MoCA为测评工具，无痴呆ACS患者认知功能障碍的神经心理学特点以执行能力、视空间功能、注意力及延迟回忆受损为主。Objective To investigate the effect of the Montreal cognitive assessment （MoCA） on screening cognitive impairment in patients with asymptmatic carotid stenosis （ACS） and the neuropsychological characteristics of ACS cognitive impairment. Methods A total of 72 consecutive patients who met the study criteria were prospectively enrolled in the study. The patients were divided into either an ACS group （n =36） or a control group （n = 36） according to the degree of carotid stenosis （I〉50% or 〈 50% ） revealed by computed tomographic angiography （CTA）. The MoCA and mini-mental state examination （MMSE） were used for cognitive assessment of the patients. The total MoCA scores, each subproject＇s score, and MMSE scores of the two groups were compared. Results （~） There were no significant differences in the baseline characteristics and vascular risk factors between the two groups （ P 〈 0.05 all ）. The positive rate of cognitive impairment （80.6%） of the MoCA method was higher than that （ 13.9% ） of the MMSE method in the ACS group. There was significant difference （ P 〈 0.01 ）. The positive rate of cognitive impairment （38.9%） of the MoCA method was higher than that of the MMSE method （5.6%） in the control group. There was significant difference （ P 〈 0.01 ）. ②The total MoCA score in the ACS group was lower than that the control group （21.5 [ 10-29] vs. 25 [ 14-28] ,P =0. 001 ）. The scores of all subprojects showed that the scores of executive function （ 0 [ 0 - 1 ] vs. 1 [ 0 - 1 ] ） ; P = 0. 004 ）, visuospatial function （3 [0-4] vs. 3.5 [0-4] ,P =0. 004）, attention （5 [2-6] vs. 6 [4-6] ,P= 0. 001 ）, and delayed recall （2 [ 0 -5 ] vs. 3 [ 0 -5 ] ,P = 0.038 ） of the ACS group were lower than those of the control group. There were significant differences. Conclusion MoCA is more sensitive than MMSE in the detection of cognitive impairment in non-dementia patients with ACS. Using MoCA as an assessmenttool, the neuropsychological char

关 键 词：颈动脉狭窄 认知 蒙特利尔认知评估量表 

分 类 号：R743.3[医药卫生—神经病学与精神病学]