简易智能精神状态量表和蒙特利尔认知评估量表差值在老年期痴呆鉴别诊断中的价值  

Diagnostic significance of the difference values between Mini-Mental State Examination and Montreal Cognitive Assessment in elderly patients with dementia

作　　者：张筱[1] 袁欣瑞[1] 朱瑞[1] 崔艺耀[1] 彭丹涛[2] 

机构地区：[1]北京医院神经内科,100730 [2]中日友好医院神经内科

出　　处：《中华老年医学杂志》2015年第5期494-497,共4页Chinese Journal of Geriatrics

基　　金：国家自然科学基金项目（30971000）

摘　　要：目的探讨简易智能精神状态量表（MMSE）和蒙特利尔认知评估量表（MoCA）差值在老年期痴呆鉴别诊断中的价值。方法收集就诊于我院门诊老年期痴呆患者331例，其中阿尔茨海默病（AD）组148例，血管性痴呆（VaD）组87例，混合性痴呆（MD）组44例，额颞叶痴呆（FTD）组41例，路易体痴呆（DLB）组11例，应用MMSE和MoCA分别评定痴呆患者的认知功能。结果AD组MMSE与MoCA差值为（3．3±1．7）分，VaD组差值为（6．6±2．1）分，MD组差值为（6．6±2．1）分，FTD组差值为（5．4±2．3）分，DLB组差值为（6．1±1.9）分。5组间差异有统计学意义（F=46．420，p=0．000），AD组与非AD组比较差异有统计学意义（t=-13．429。P=0．000）。轻、中度痴呆中，AD组和非AD组比较，MMSE和MoCA差值均有统计学意义（P=0．000）。根据R0c曲线，确定MMSE与MoCA差值一5分为鉴别AD和非AD痴呆的切点，对应的敏感度和特异度分别为79．8％和78．4％，ROC曲线下面积为0．848，95％CI为0．807～0．890。结论MMSE与MoCA差值可作为鉴别AD和非AD痴呆的辅助诊断方法之一。Objective To investigate the diagnostic significance of the difference values between Mini-Mental State Examination （MMSE） and Montreal Cognitive Assessment （MoCA）in elderly patients with dementia. Methods 331 elderly patients with dementia were collected from out- patients in our hospital. There were 148 people with Alzheimerrs disease （AD）, 87 cases with vascular dementia （VaD）, 44 cases with mixed dementia （MD）, 41 cases with frontotempora[ dementia （FTD） and 11 cases with dementia with Lewy bodies （DLB）. MMSE and MoCA were applied to test the cognitive impairment separately. Results The difference values between MMSE and MoCA was （3.3±1.7） points, （6.6±2.1） points, （6.6±2.1） points, （5.4±2.3） points, （6.1 ±1. 9） points in AD, VaD, MD, FTD and DLB group respectively, and there were statistical differences among the five groups （ F= 46. 420, P= 0. 000）. Statistical differences were found in the difference values between MMSE and MoCA between dementia patients with AD and non-AD （t=- 13. 429, P= 0. 000）. According to receiver operating characteristic curve （ROC curve）, the optimal cut off point of the difference values between MMSE and MoCA for differential diagnosis between AD and non-AD dementia was 5 points, with 79.8% sensitivity and 78.4% specificity, and area under the curve was 0. 848 （95%CI：0. 807-0. 890）. Conclusions The difference values between MMSE and MoCA may be one of parameters for differential diagnosis between AD and non-AD dementia.

关 键 词：痴呆 精神病状态评估量表 认知 

分 类 号：R749.16[医药卫生—神经病学与精神病学]