Stroop测验在无症状脑梗死认知功能评价中的应用价值  

Application value of Stroop test in the evaluation of cognitive function in asymptomatic cerebral infarction

作　　者：白秋菊 胡军[3] 张琳静 陈域 张彦海 王鲜婵 迟丽屹 BAI Qiu-ju;HU Jun;ZHANG Lin-jing;CHEN Yu;ZHANG Yan-hai;WANG Xian-chan;CHI Li-yi(986th Hospital,Air Force Military Medical University,Xi'an,Shaanxi 710000,China;The Second Clinical Medical College,Shaanxi University of Traditional Chinese Medicine,Xianyang,Shanxi 712000,China;Department of Neurology,Shaanxi Provincial People's Hospital,Xi'an,Shaanxi 710000,China;Unit 91395 of PLA,Beijing 100000,China)

机构地区：[1]空军军医大学第九八六医院,陕西西安710000 [2]陕西中医药大学第二临床医学院,陕西咸阳712000 [3]陕西省人民医院神经内科,陕西西安710000 [4]中国人民解放军91395部队,北京100000

出　　处：《阿尔茨海默病及相关病杂志》2021年第4期269-274,共6页Chinese Journal of Alzheimer's Disease and Related Disorders

摘　　要：目的:对比简易智力状态检查量表(MMSE)、蒙特利尔认知评估量表MoCA及改良版斯特鲁普色词测验(C-Stroop)在无症状脑梗死(SBI)人群认知功能评价中的应用价值。方法:选取2019年12月至2021年1月空军第九八六医院神经内科门诊或住院人员,共126名受试者(正常组、SBI组及脑梗死组各42名),受试者均完成MMSE、MoCA及C-Stroop后,对比各组工作特征(ROC)曲线。结果:正常组和SBI组的MMSE、MOCA评分及C-Stroop正确数明显低于脑梗死组(P<0.01),C-Stroop耗时均明显增加(P<0.01)。正常组和SBI患者MMSE、MOCA评分差异无统计学意义(P>0.05),C-Stroop正确数明显低于SBI组(P<0.01),C-Stroop耗时均明显增加(P<0.01)。3种测试均对于SBI和脑梗死组、正常人群和脑梗死组认知功能评定具有良好的区分度(ROC下面积均>0.8);C-Stroop对正常组和SBI组之间进行鉴别时,灵敏度、特异度、曲线下面积(AUC)明显优于MMSE、MoCA评分,MMSE评分(0.024、1、0.469),MoCA评分(0.262、0.905、0.533),C-Stroop任务C的正确数(0.762、0.857、0.809)及耗时(0.548、0.905、0.723)。C-Stroop任务C正确数对与正常人和SBI的截断值为21.5(AUC=0.809),SBI和脑梗死人群截断值为14.5(AUC=0.946),正常人和脑梗死截断值为16.5(AUC=0.994);C-Stroop任务C耗时对与正常人和SBI的截断值为38.1515(AUC=0.723),SBI和脑梗死人群截断值为42.692(AUC=0.832),正常人和脑梗死截断值为39.0075(AUC=0.942)。结论:C-Stroop在SBI患者认知功能评价中较MMSE、MoCA具有更高的灵敏度和特异度,推荐用于SBI患者的认知功能评价、快速筛查。Objective:To compare the application value of MMSE,MoCA and modified Version of Stroop in the evaluation of cognitive function in patients with silent brain infarction(SBI).Methods:A total of 126 subjects(normal group,SBI group and cerebral infarction group 42 in each group)were selected from outpatient or inpatient department of neurology,986 Hospital of Air Force from December 2019 to January 2021.After completing MMSE,MoCA and C-StroOP,ROC curves of each group were compared.Results:MMSE,MOCA score and the correct number of C-Stroop in normal group and SBI group were significantly lower than those in cerebral infarction group(P<0.01),and the time of C-stroop was significantly increased(P<0.01).There were no significant differences in MMSE and MOCA scores between normal group and SBI group(P>0.05),the correct number of C-Stroop was significantly lower than that of SBI group(P<0.01),and c-Stroop time was significantly increased(P<0.01).All the three tests showed good differentiation between SBI and cerebral infarction group,normal population and cerebral infarction group(area under ROC was greater than 0.8).The sensitivity,specificity and area under curve(AUC)of C-Stroop were significantly better than those of MMSE and MoCA scores,MMSE score(0.024,1,0.469),MoCA score(0.262,0.905,0.533),correct number of C-Stroop task C(0.762,0.857,0.809)and time consuming(0.548,0.905,0.723).The truncation value of correct number pairs of C-stroop task was 21.5(AUC=0.809),14.5(AUC=0.946)and 16.5(AUC=0.994)for SBI and cerebral infarction patients.The truncation value of C-stroop task C time between normal subjects and SBI was 38.1515(AUC=0.723),the truncation value between SBI and cerebral infarction group was 42.692(AUC=0.832),and the truncation value between normal subjects and cerebral infarction was 39.0075(AUC=0.942).Conclusions:C-Stroop has higher sensitivity and specificity than MMSE and MoCA in the evaluation of cognitive function in SBI patients,and is recommended for the evaluation and rapid screening of cognitive functio

关 键 词：无症状脑梗死 Stroop测验 MMSE MOCA 认知功能 

分 类 号：R741[医药卫生—神经病学与精神病学]