神经心理测验对痴呆诊断的贡献与误区  

Functions and limitations of neuropsychological tests on diagnosis of dementia

作　　者：赵洁皓[1] 张振馨[1] 洪霞[1] 黄觉斌[1] 魏镜[1] 吴继星[2] 杨恩立[2] 

机构地区：[1]中国医学科学院中国协和医科大学北京协和医院神经科,100730 [2]北京市第六医院神经科

出　　处：《中华神经科杂志》2002年第6期333-335,共3页Chinese Journal of Neurology

基　　金："九五"国家科技攻关项目( 96 0 96 0 5 0 1)

摘　　要：目的　评价神经心理测验 (NPT)对痴呆诊断的作用及局限性。方法　痴呆组 2 70例 ,非痴呆组 61 7名 ,进行简易精神状态检查、Fuld物体记忆测验、言语流畅性测验、数字广度测验和积木测验。结果　痴呆和非痴呆组NPT得分差异有显著意义。 4个测验特异性高在 72 %～ 99%之间 ,随文化水平的增高而降低。在筛查的基础上加用NPT ,诊断准确性由 68%提高到 80 %～ 89%。文化、年龄、性别对NPT有显著影响。结论　NPT可提高痴呆诊断的准确性。本组NPT适合于我国低文化老人的痴呆调查 。Objective To assess the functions and limitations of neuropsychological tests (NPT) for diagnosisg of dementia Methods Totally 887 residents drawn from an epidemiological study of enrolled dementia, had completed psychometric tests, including Fuld Object Memory Evaluation (FOM), Rapid Verbal Retrieve (RVR), Block Design (BD), and Digit Span (DS). 270 cases were diagnosed as having dementia according to DSM IV criteria, and 617 subjects were nodemented. We analyzed the distribution of scores for tests between cases and nodemented persons as to assessing the value of psychometric test in diagnosing dementia. By a fitting multiple regression model the influence of the factors on test scores was assessed Results Scores on all tests have significant differences between dementia and nodemented groups. All tests showed higher specificity, between 72～99%, and sensitivity is between 22 90%. The sensitivity of BD and DS showed a tendency decreasing obviously with the educational level increase. With the use of NNPT in addition of screening test, the accuracy of diagnosis increases from 68% to 80～89%.The differences in education, sex and age may always influence the four tests Conclusion Psychometric tests might improve the accuracy of diagnosis for dementia. The four psychometric tests may serve as a suitable instrument for poor education people in our country, but the sensitivity for well educated people may be low that for those,the other tests might be further needed.

关 键 词：神经心理测验 痴呆 诊断 老年人 

分 类 号：R749.16[医药卫生—神经病学与精神病学]