中文版约翰霍普金斯改编认知检查量表在呼吸重症患者中的初步应用研究  

Preliminary study of application of Johns-Hopkins Adapted Cognitive Exam(Chinese version)in the respiratory intensive care unit patients

作　　者：封景文 虞琰 卢浩 张瑜[1] 张一[1] FENG Jingwen;YU Yan;LU Hao(Department of Rehabilitation Medicine,the First People's Hospital of Changzhou,Changzhou,Jiangsu,213000)

机构地区：[1]常州市第一人民医院康复医学科,江苏省常州市213000

出　　处：《中国康复医学杂志》2024年第12期1853-1857,共5页Chinese Journal of Rehabilitation Medicine

摘　　要：目的:探讨中文版约翰霍普金斯改编认知检查量表(the John Hopkins adapted cognitive exam,ACE)在呼吸危重症患者中应用的有效性,为其在国内临床应用提供客观依据。方法:选择2022年10月—2023年10月100例呼吸重症监护病房(respiratory intensive care unit,RICU)患者作为RICU组和40例同期体检的健康人作为对照组,分别用简易精神状态量表(mini-mental state examination,MMSE)和中文版ACE评估其认知功能。结果:(1)RICU组ACE总分和MMSE总分呈显著相关(r=0.709,P<0.001);两者相同子项目相关系数在0.444—0.804,低度至高度相关;中文版ACE各子项目与ACE总分低度至高度显著相关,相关系数在0.438—0.769(P<0.001)。(2)RICU组和对照组间,在中文版ACE中定向力、模仿能力、记忆能力及总分均有显著性差异(P<0.05),在MMSE中定向力、注意力与计算力、回忆能力、语言能力和总分均有显著性差异(P<0.05)。(3)中文版ACE总分90.5时约登指数最大(0.49),MMSE总分26.5时约登指数最大(0.525)。受试者操作曲线曲线下面积ACE为(0.813±0.035),MMSE为(0.841±0.032),两者无显著差异(Z=1.00,P=0.317)。结论:中文版ACE可以作为RICU患者认知障碍筛查的工具,且较MMSE更适宜在气管插管、气管切开及使用机械通气患者中使用。Objective:To investigate the effectiveness of the Chinese version of the Johns Hopkins Adapted Cognitive Exam(ACE)in patients with respiratory critical illness,and to provide objective evidence for its clinical application in China.Method:One hundred patients in RICU from October 2022 to October 2023 were selected as RICU group and 40 healthy participants during physical examination during the same period as control group,and their cognitive function was evaluated by MMSE and ACE,respectively.Result:①There were significant correlations between ACE score and MMSE score in RICU group(r=0.709,P<0.001);The correlation coefficients of the same subitems were 0.444—0.804,and the correlation was low to high.The Chinese version ACE items were lowly to significantly correlated with the ACE total score,with correlation coefficients ranging from 0.438 to 0.769(P<0.001).②Between RICU group and control group,there were significant differences in orientation,imitation ability,memory ability and total score in Chinese ACE(P<0.05),and significant differences in orientation,attention and calculation ability,recall ability,language ability and total score in MMSE(P<0.05).③The Chinese version has the highest Yoden index(0.49)when the ACE score is 90.5,and the highest Yoden index(0.525)when the MMSE score is 26.5.The area under the receiver operation curve(ACE)was(0.813±0.035)and the MMSE was(0.841±0.032),and there was no significant difference between them(Z=1.00,P=0.317).Conclusion:The Chinese version of ACE can be used as a screening tool for cognitive impairment in RICU patients,and is more suitable for use in patients with tracheal intubation,tracheotomy and mechanical ventilation than MMSE.

关 键 词：中文版约翰霍普金斯改编认知检查量表 呼吸危重症患者 认知障碍 简易精神状态量表 效度 

分 类 号：R493[医药卫生—康复医学] R563[医药卫生—临床医学]