画钟系列实验错误分析在识别老年MCI及早期AD患者中的临床分析  

作　　者：曹岩菁[1] 林萍[1] 金牡丹 郑凤鸣[1] 李鹏[1] 梁丽贞[1] 

机构地区：[1]杭州市第三人民医院老年科,310009

出　　处：《浙江临床医学》2016年第10期1843-1845,共3页Zhejiang Clinical Medical Journal

基　　金：杭州市科技局课题项目（编号：20130633823）

摘　　要：目的：比较画钟实验（CDT）、钟表读数实验（CRT）及钟表设置实验（CST）错误分析对筛查轻度认知功能障碍（MCI）、早期及中晚期阿尔茨海默病（AD）患者的临床意义。方法182例受试者中，经简易痴呆量表（MMSE）筛查，45例为MCI患者，38例为早期AD患者，25例为中重度AD患者。74例为健康者。受试者分为正常健康组、MCI组和早期AD组。所有受试者均给予MMSE、CDT、CRT、CST测试。结果曲线下面积（AUC）分析CDT、CRT及CST在区分早期AD患者中灵敏度及专一性较高，但在区分MCI患者中差异无显著性。CDT-16的敏感性及专一性分别为40.69%和90%，CDT-4为30.49%和78.07%，CDT-16的敏感性和专一性高于CDT-4（P〈0.05）。在区分早期AD中，CDT-16的敏感性及专一性分别为88.71%和90%，CDT-4为72%和85.62%（P〈0.05）。结论 CDT-16分制错误分析可以作为一个诊断MCI的有效工具，值得临床推广。ObjectiveTo investigate the sensitivity and specificity of the Clock Drawing Test（CDT）combined with the clock reading （CRS）and clock setting test（CST）to screen the mild cognitive impairment and early AD patients in the elderly.MethodsAll of the subjects were recruited from the outpatient department of the Third Hospital of Hangzhou and the memory disorder clinic and Healthy controls were recruited from the hospital. All the subjects were given MMSE,SPMT,CDT and CRT. According to the test results,the 182 subjects were divided into normal group, mild cognitive impairment group,early AD group and progressed AD group. In the 3 groups,with 45 of the dementia diagnosed with mild cognitive impairment,38 were early Alzheimer＇s disease,25.ResultsThe high sensitivity and specificity of CDT,CST,CRT in diagnose of early AD patients. There was no significant difference in the sensitivity and specificity among CDT,CST and CRT in diagnose of MCI. CDT-16 point in patients with MCI were 40.69% and 90% compared with CDT-4 point（30.49% and 78.07%）,it was significantly higher than the latter. However,there was no significant difference in the sensitivity and specificity between CDT-16 point（88.71% and 90%）,CDT-4 point（72.0% and 85.62%）in diagnosis of early AD（P〈0.05）.Conclusions 16–point CDT error score can be used as an effective approach to screen the mild and early cognitive impairment in the elderly.

关 键 词：画钟实验 错误分析 阿尔茨海默病 

分 类 号：R563.1[医药卫生—呼吸系统]