Stroop色词测验在早期识别卒中后认知障碍中的作用研究  

Early Detection of Post-stroke Cognitive Impairment by Stroop Color Word Test

作　　者：张君芳 姜帅[2] 赵晓玲[2] 王蕾[2] 方升[2] 朱曦[2] 何柳[2] 辜蕊[2] 李立[2] 刘艳[2] ZHANG Junfang;JIANG Shuai;ZHAO Xiaoling;WANG Lei;FANG Sheng;ZHU Xi;HE Liu;GU Rui;LI Li;LIU Yan(Department of Neurology,the Affiliated Hospital of Southwest Medical University,Luzhou 646000,China;Department of Neurology,the Third People's Hospital of Chengdu,Chengdu 610031,China)

机构地区：[1]西南医科大学附属医院神经内科,四川省泸州市646000 [2]四川省成都市第三人民医院神经内科,610031

出　　处：《中国全科医学》2021年第15期1896-1902,共7页Chinese General Practice

基　　金：四川省卫生健康委员会科研课题普及项目(19PJ169)。

摘　　要：背景卒中后认知障碍(PSCI)作为急性脑梗死并发症之一,严重影响患者生活质量,增加患者家庭及社会经济负担。目前用于评估急性脑梗死患者认知功能的量表存在耗时长、灵敏度有限、患者配合差等问题,因此需要探索操作更方便快捷、灵敏度更高的评估工具。目的探究Stroop色词测验在早期识别PSCI中的作用。方法选取2019年10月—2020年6月于成都市第三人民医院神经内科住院治疗的急性脑梗死患者174例为研究对象,依据北京版蒙特利尔认知评估量表(MoCA)总分将患者分为认知障碍组(PSCI组)、非认知障碍组(NPSCI组)。采用Stroop色词测验评估两组患者执行功能,比较两组患者的执行功能,并进一步分析Stroop色词测验指标与MoCA总分及其各认知域评分的相关性。绘制Stroop色词测验指标诊断急性脑梗死患者发生PSCI的受试者工作特征(ROC)曲线。结果依据MoCA评估结果,PSCI组130例,平均MoCA总分为(18.2±4.2)分;NPSCI组44例,平均MoCA总分为(25.3±2.2)分;急性脑梗死患者PSCI发生率为74.7%(130/174)。PSCI组患者年龄大于NPSCI组(P<0.05)。PSCI组患者卡片A、B、C耗时和Stroop色词测验干扰量(SIE)耗时、SIE正确数、正确数递减率、卡片A耗时/正确数、卡片B耗时/正确数、卡片C耗时/正确数高于NPSCI组,卡片B、C正确数低于NPSCI组(P<0.05)。卡片A耗时、卡片B耗时、卡片C耗时、SIE正确数、正确数递减率、卡片A耗时/正确数、卡片B耗时/正确数、卡片C耗时/正确数均与MoCA总分及视空间与执行功能、命名、注意力、语言、抽象思维、延迟回忆、定向力评分呈负相关(P<0.05),卡片B、C正确数与之呈正相关(P<0.05);SIE耗时与MoCA总分、视空间与执行功能、语言、延迟回忆、定向力评分均呈负相关(P<0.05)。卡片C耗时、SIE正确数、正确数递减率、卡片C耗时/正确数诊断急性脑梗死患者发生PSCI的灵敏度分别为87.7%、76.2%、76.Background Post-stroke cognitive impairment(PSCI)is one of the complications of acute cerebral infarction,which seriously affects the quality of life and increases the burden on patients'families and social economy.Current available scales used to assess the cognitive function of stroke patients have problems such as longer time consuming,limited sensitivity,and poor cooperation of patients.So there is a need to explore a more convenient and sensitive assessment tool.Objective We aimed to explore the applicability of Stroop color word test(SCWT)on PSCI in the early stage.Methods 174 patients with acute cerebral infarction who were hospitalized in the Department of Neurology of the Third People's Hospital of Chengdu from October 2019 to June 2020 were selected.The Beijing version of the Montreal Cognitive Assessment(MoCA)was used to screen cognitive impairment.The SCWT was used to assess the executive function of patients with and without cognitive impairment.The correlation of the indictors of SCWT with the scale and each cognitive domain score of the MoCA was analyzed.The ROC curve of the indictors of SCWT in predicting PSCI was plotted and analyzed.Results One hundred and thirty cases were found with PSCI,accounting for 74.7%(130/174),with an average scale score of MoCA of(18.2±4.2)points,other 44 without PSCI had an average scale score of MoCA of(25.3±2.2)points.PSCI group had a greater average age(P<0.05).PSCI group used more time to finish card A,B,and C,had greater completion time of SIE(the difference between completion time for card C and that for card B),more correct response number of SIE,higher decline rate of correct response number,higher ratio of completion time for card A,B,or C to correct response number and less correct response numbers of cards B and C on average(P<0.05).The completion time for card A,B or C,correct response number of SIE,decline rate of correct response number,ratio of completion time for card A,B or C to correct response number were negatively correlated with the scale score

关 键 词：脑梗死 卒中后认知障碍 Stroop色词测验 执行功能 诊断 

分 类 号：R743.33[医药卫生—神经病学与精神病学]