Richmond躁动镇静评分量表评估电休克治疗后谵妄的信度及效度  

Reliability and validity of Richmond agitation-sedation scale on post-electroconvulsive therapy delirium

作　　者：杨雪[1,2] 王喜今 姜玮[2] 任艳萍[2] 姜长青[2] 汤宜朗[2,3] 

机构地区：[1]黑龙江省哈尔滨市第一专科医院精神科,150056 [2]首都医科大学附属北京安定医院 [3]Emory University School of Medicine USA

出　　处：《临床精神医学杂志》2016年第2期86-88,共3页Journal of Clinical Psychiatry

摘　　要：目的:探讨中文版Richmond躁动镇静评分量表(RASS)评估电休克治疗(ECT)后谵妄状态(PECTD)的信度和效度。方法:对335例MECT呼吸恢复后的患者分别进行美国《精神障碍诊断及统计手册》第4版修订版(DSM-IV-TR)谵妄诊断、RASS及格拉斯哥昏迷量表(GCS)评估;以DSM-IV-TR诊断为金标准,分析RASS评估PECTD灵敏度及特异度;采用受试者工作特征曲线(ROC曲线)下面积确定RASS诊断不同亚型PECTD的最佳划界值。结果:RASS评分者的一致性(Kappa值)为0.733;RASS为+1分时诊断活动增多型PECTD灵敏度、特异度分别为94.9%、91.8%,RASS为-1分时诊断活动减少型PECTD灵敏度、特异度分别为93.2%、95.6%。RASS与GCS评分呈正相关(r=0.891,P<0.001)。结论:RASS评估PECTD有良好的信度和效度;其诊断活动增多型及活动减少型PECTD的最佳划界值为分别为+1及-1分。Objective： To explore the reliability and validity of the Richmond agitation sedation scale（ RASS） of Chinese version on post-electroconvulsive therapy（ ECT） delirium（ PECTD）. Method： The delirium was diagnosed using DSM-IV-TR（ the diagnostic and statistical manual of mental disorders,APA） criterion,and was assessed using RASS and Glasgow coma scale（ GCS）. With DSM-IV-TR as the ＂ gold standard＂ for PECTD diagnosis,the sensitivity and specificity of RASS were analyzed. The best cutoff value of different subtypes PECTD diagnosed by RASS was calculated by the area under the curve of ROC. Results： The consistency of RASS raters was（ Kappa value） 0. 733,（ P〈 0. 001）. When RASS score was ＋ 1,the sensitivity and specificity for hyperactive PECTD were 94. 9% and 91. 8%,respectively. When RASS score was- 1,the sensitivity and specificity for hypoactive PECTD were 93. 2%,95. 6% respectively. The scores of RASS and GCS had positive correlation（ r = 0. 891,P 〈0. 001）. Conclusion： RASS for evaluating PECTD has a good reliability and validity. The best cutoff scores of RASS for hyperactive and hypoactive PECTD are ＋ 1 and- 1 respectively.

关 键 词：电痉挛治疗后谵妄状态 Richmond躁动镇静评分量表 信度 效度 

分 类 号：R749[医药卫生—神经病学与精神病学]