ADDENBROOKE’S 认知功能检查-中文版用于轻度认知功能障碍患者评估的初步探究  

Application of Chinese version of Addenbrooke’s cognitive examination for screening mild cognitive impairment

作　　者：王彩霞[1] 刘国荣[1] 梁芙茹[1] 樊宇[1] 孙咏婕 WANG Caixia;LIU Guorong;LIANG Furu;FAN Yu;SUN Yongjie(Department of Neurology,Baotou Central Hospital,Baotou 014000,China)

机构地区：[1]包头市中心医院

出　　处：《包头医学院学报》2019年第9期1-5,15,共6页Journal of Baotou Medical College

摘　　要：目的:研究ACE-Ⅲ(ADDENBROOKE’S认知功能检查-中文版)在筛查轻度认知障碍(Mild cognitive impairment,MCI)中的应用价值,初步探讨ACE-Ⅲ筛查MCI的最佳界值。方法:选择MCI患者51例,另选同期认知功能正常者50例,分别对入组的受试者采用ACE-Ⅲ、蒙特利尔认知评估量表(Montreal cognitive assessment,MoCA)、简易精神状态量表(mini-mental status examination,MMSE)进行评估,分析年龄、性别、文化程度对三种量表的影响,进行3种量表的相关性分析,并且计算三种量表筛查MCI患者的敏感性、特异性、约登指数等,分别绘制三种量表的ROC曲线,并选取最佳分界值。结果:(1)年龄与ACE-Ⅲ、MoCA、MMSE的得分呈负相关,教育年限与三种量表的得分成正相关,性别与之无相关性。(2)ACE-Ⅲ和MoCA、MMSE的组间信度(ICC)分别为(0.809、0.80),ACE-Ⅲ、MoCA、MMSE的重测信度(Pearson系数)分别为(0.8、0.7、0.9)。ACE-Ⅲ有很好的内部一致性,其α=0.894。ACE-Ⅲ的5个子域Cronbach’s信度系数α分别为:注意力=0.755,记忆=0.77,词语流畅性=0.78,语言=0.77,视空间=0.83,表明每一项都是ACE-Ⅲ必需的。(3)ACE-Ⅲ具有良好的可靠性以及真实性。在筛查MCI,ACE-Ⅲ最佳截点为82/83时的灵敏度(0.96)优于MoCA(22/23最佳截点,0.92),也优于MMSE(最佳截点26/27,78)。在筛查MCI时,ACE-Ⅲ的ROC曲线下的面积(0.94)比MoCA大(0.863),比MMSE大(0.767)。(4)在筛查MCI时,ACE-Ⅲ的阳性预测值高于MMSE与MoCA。结论:年龄与ACE-Ⅲ与MoCA、MMSE得分呈负相关,教育年限与三种量表呈正相关,性别与之无相关性。在筛查MCI方面,ACE-Ⅲ与MoCA、MMSE有很好的相关性,并且与临床诊断一致性好,且ACE-Ⅲ优于MoCA及MMSE。ACE-Ⅲ具有很好的内部一致性、良好的可靠性以及真实性。Objective:To study the application of Chinese version of Addenbrooke’s Cognitive Examination(ACE-III)in screening mild cognitive impairment(MCI)and its optimal cut-off value.Methods:51 patients with mild cognitive impairment and 50 normal people were selected as the subjects.ACE-III,Montreal Cognitive Assessment(MoCA),Mini-Mental State Examination(MMSE)were adopted to analyze the effect of age,gender and education in the three assessments,and their correlation analysis was made.The sensitivity,specificity,Youden index of the three assessments were calculated to get the ROC curve,and the best cut-off value was selected.Results:1.Age was negatively related to the scores in ACE-III,MoCA and MMSE,educational years was positively related to the scores in ACE-III,MoCA and MMSE and gender had no correlation.2.The reliability(ICC)in the three groups were(0.809,0.80),the retest reliability(Pearson coefficient)were(0.8,0.7,0.9).ACE-III had good internal consistency(α=0.894).The 5 subdomains of Cronbach's reliability coefficientαin ACE-III were:attention=0.755,memory=0.77,verbal fluency=0.78,language=0.77 and visual-spatial=0.83,indicating that each of these was necessary for ACE-III.3.ACE-III had a good reliability and authenticity.When screening MCI,the best cut-off point and sensitivity of ACE-III is 82/83(0.96),which was better than MoCA(22/23,0.92)and MMSE(26/27,78).When screening for MCI,the area under the ROC curve of ACE-III(0.94)was greater than the MoCA(0.863)and MMSE(0.767).4.When screening MCI,the positive predictive value of ACE-III was higher than that in the MMSE and MoCA.Conclusion:The scores of ACE-III and MoCA,MMSE are negatively related to the age and positively related to the years of education and had no correlation with gender.In terms of screening for MCI,ACE-III,MoCA and MMSE have a good correlation with the clinical diagnosis and consistency,but ACE-III is better than MoCA and MMSE.ACE-III has a good internal consistency,good reliability and authenticity in screening for MCI.

关 键 词：ADDENBROOKE’S认知功能检查-中文版(ACE-Ⅲ) 蒙特利尔认知评估量表(MoCA) 简易精神状态量表(MMSE) 轻度认知功能障碍(MCI) 

分 类 号：R74[医药卫生—神经病学与精神病学]