蒙特利尔认知评估量表在血管性认知功能障碍中的临床应用研究

发布时间：2018-08-13 11:28

【摘要】：目的探讨蒙特利尔认知评估量表（Montrealcognitiveassessment,MoCA）在筛查血管性认知功能障碍患者的应用，同时与简易精神状态量表（Mini-MentalStateExamination，MMSE）进行比较研究。方法通过将研究对象分为宁夏医科大学附属医院住院及门诊VCIND患者58例为病例组，以及健康体检者62例为对照组。通过MoCA量表及MMSE量表，评价其认知功能水平，统计MoCA量表与MMSE的相关性，并通过绘制ROC曲线以及敏感度和特异度的统计分析，找出筛查VCI的最佳分界值。结果MoCA量表在筛查工作中表现出与MMSE量表良好的相关性(r＞0.8)，原26分正常分界值筛查敏感度及特异度为96.55%和80.42%。通过MoCA量表各分值对应的敏感度及特异度绘制ROC曲线，发现曲线下面积（AUC）=0.985，，MMSE量表的曲线下面积为0.841。MoCA量表分界值设置在24分时，敏感度及特异度为93.10%与89.87%，所对应的约登指数为所有分值对应的最大值（YI=0.899）。结论（1）MoCA量表操作简单，被检测者依从性好，临床使用可操作性强。（2）MoCA量表与MMSE量表评测分值具有良好相关性，可以反映被测试者的认知功能情况。（3）MoCA量表正常分界值用于筛查VCI患者可能过高，将正常分界值设置在24分时筛查VCI患者更为理想（。4）MMSE量表筛查VCI患者存在敏感度过低的情况，在筛查VCI患者的应用中，MoCA量表要优于MMSE量表。
[Abstract]:Objective to investigate the application of Montreal Cognitive Assessment scale (MOCA) in screening patients with vascular cognitive impairment and to compare it with Mini-MentalStateExaminationMMSE (Mini-MentalStateExaminationMMSE). Methods the subjects were divided into two groups: 58 inpatients and outpatients with VCIND in affiliated Hospital of Ningxia Medical University, and 62 healthy persons as control group. The cognitive function of MoCA and MMSE were evaluated, and the correlation between MoCA and MMSE was analyzed. The best threshold of VCI screening was found by drawing ROC curve and statistical analysis of sensitivity and specificity. Results the MoCA scale showed a good correlation with MMSE scale (r > 0. 8). The sensitivity and specificity of normal threshold of 26 scores were 96.55% and 80.42% respectively. The sensitivity and specificity of each score of MoCA scale were used to draw the ROC curve. It was found that the area under the curve area of (AUC) 0.985 MMSE scale was when the threshold of 0.841.MoCA scale was set at 24 points. The sensitivity and specificity were 93.10% and 89.87% respectively. The corresponding Jordan index was the maximum value (YI=0.899) of all the scores. Conclusion (1) the MoCA scale is simple in operation, good in compliance and maneuverability in clinical use. (2) there is a good correlation between the MoCA scale and the evaluation score of MMSE scale. It can reflect the cognitive function of the subjects. (3) the normal threshold value of MoCA scale may be too high for screening patients with VCI. It is more ideal to screen VCI patients with normal threshold value at 24 minutes. (.4) there is a low sensitivity in the screening of VCI patients with MMSE scale. In screening for VCI patients, the MoCA scale was superior to the MMSE scale.
【学位授予单位】：宁夏医科大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R749.1

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