Cog-12量表在筛查慢性肾衰竭患者认知功能障碍中的应用  

Application of Cog-12 scale in patients with chronic renal failure

作　　者：韦存胜[1] 徐俊[2] 孙彬[3] 申志祥[1] 顾小花[1] 蔡荇[2] 孙奕[1] 张长春[1] 余婕[4] 戴春笋 

机构地区：[1]南京医科大学附属江苏省老年医院神经内科,210024 [2]江苏省苏北人民医院神经内科 [3]南京医科大学附属江苏省人民医院肾内科 [4]南京医科大学附属南京儿童医院儿科 [5]南京医科大学附属第二临床医院肾内科

出　　处：《中国神经免疫学和神经病学杂志》2014年第5期319-322,共4页Chinese Journal of Neuroimmunology and Neurology

基　　金：国家自然科学基金资助项目(项目编号:81271211;30700248);科技部重大新药创制项目(项目编号:2012ZX09303005-002);江苏省神经退行性疾病重点实验室开放课题项目(项目编号:SJ11KF05);江苏省科技支撑计划(社会发展)项目(项目编号:BE2011614)

摘　　要：目的初步探讨认知障碍简明评价表(cognitive-12scale,Cog-12)在筛查慢性肾衰竭(chronic renal failure,CRF)患者认知功能障碍中的应用价值。方法招募南京地区四所三甲医院肾内科门诊及住院治疗的临床确诊的CRF患者共171例,按认知障碍诊断标准分为认知功能正常组、轻度认知功能障碍组(MCI)及痴呆组。采用Cog-12量表通过询问照料者对患者进行测评,采用Addenbrooke改良认知评估量表(Addenbrooke cognitive examination revised,ACE-R)对各组患者进行神经心理评估,分析Cog-12量表、简易智能筛查量表(mini-mental state of examination,MMSE)与ACE-R结果的相关性。结果 (1)CRF患者Cog-12量表评分与ACE-R评分呈显著负相关(r=-0.909),且相关程度显著优于MMSE(r=0.847)。(2)Cog-12对于CRF患者MCI的识别能力明显优于AD8(AUCCog-12=0.834;AUCAD8=0.802),在界值设定为5/6时,Cog-12量表对MCI的筛查效果最佳(敏感度0.769、特异度0.650、约登指数0.419)。结论 Cog-12量表可有效检测CRF患者的认知功能损伤,同时易于发现早期轻度的认知功能损伤,可用于临床CRF患者认知功能的筛查。Objective To explore the value of cognitive-12 scale in screening cognitive impairment in chronic renal failure （CRF） patients.Methods We recruited 171 patients with CRF from hospitals of Nanjing urban.The patients were divided into normal cognition group,mild cognitive impairment group （MCI）,and dementia group （Dem）.The Cog-12 scale was applied for caregivers,and the Addenbrooke＇s Cognitive Examination Revised （ACE-R） scale was performed to evaluate the cognitive function of each groups.One-way ANOVA,receiver operating characteristic （ROC） curve and other statistical methods were applied to compare the results.Results （1） The Cog-12 scale scores showed a significantly negative correlation with ACE-R scores （correlation coefficient r=-0.909） in CRF patients,and the degree of correlation was significantly better than the mini-mental state of examination scale （MMSE） （correlation coefficient r=0.847）.（2） Cog-12 scale had a better ability to recognize MCI in patients with CRF than AD8 scale （Cog-12：AUC=0.834; AD8：AUC=0.802）,and cut-off scores 5/6 had the best ability to identify MCI （sensitivity 0.769,specificity 0.650,Youden index 0.419）.Conclusions Cog-12 scale is suitable to screen cognitive impairment in CRF patients.Compared with the ACE-R scale,Cog-12 scale possesses ideal effectivity to screen cognitive impairment in patients with CRF.In particular,Cog-12 scale has a good ability of identifying MCI in patients with CRF,therefore,it is suitable for clinical application and generalization.

关 键 词：肾功能衰竭 慢性 认知障碍 认知筛查量表 

分 类 号：R692[医药卫生—泌尿科学]