蒙特利尔认知评估量表与简易精神状态量表在脑白质疏松患者中的应用比较

目的比较蒙特利尔认知评估量表（MOCA）和简易精神状态量表（MMSE）对脑白质疏松（LA）患者认知功能障碍的筛查能力，并了解lA患者认知功能受损的特点。方法应用MoCA量表及MMSE量表对56倒LA患者及50例对照的认知功能进行测评，比较两组的测试结果，并比较两量表对LA组中VCI患者的诊断能力。结果LA组的MoCA总评分（20．34±3．00）分明显低于对照组（22．20±2．26）分，差异有统计学意义（t-4．02，P〈O．01）；其中，LA组的命名、语言、抽象、定向力评分均小于对照组，差异有统计学意义（t分别为3．92，3．43，4．02，5．35；P〈0．01）。LA组的MMSE总评分（27．54±1．36）分低于对照组（28．06±1．92）分，差异有统计学意义（t-2．36，P〈0．05），其中LA组的定向力及延迟回忆评分低于对照组，差异有统计学意义（t分别为2．68，2．60；P〈0．05）。在LA组中，MoCA诊断VCI的敏感度为93．9％、特异度63．6％、假阳性率36．4％、假阴性率9．1％、阳性预测值91．3％、阴性预测值70．0％、诊断符合率84．2％、约登指数0．569；MMSE诊断VCI的上述指标分别为26．7％，90．9％，6．7％，73．3％，92．3％，23．3％，43．4％，0．176。结论LA患者的认知功能受损表现在命名、语言、抽象、定向力及延迟回忆等方面。MoCA量表在筛查LA患者认知功能方面比MMSE量表更敏感。

Comparison of application between Montreal Cognitive Assessment Scale and Mini-Mental State Examination Scale in patients with leukoaraiosis

Objective To compare the ability of Montreal Cognitive Assessment Scale （MoCA） and Mini Mental State Examination Scale （MMSE） in screening cognitive impairment in patients with leukoaraiosis （I.A）, and to explore the eharaeterislics of cognitive dysfunction in patients with I.A. Methods The cognitive function of 56 patients with LA and 50 controls were assessed with MMSE and MoCA. The performance of cognitive domain was compared between the two groups. The diagnostic effect of MoCA and MMSE in vascular cognitive impairment （VCI） diagnosis were compared in I.A group. Results The total scores of MoCA in LA group（20.34±3.00） were obviously lower than that in the control group （22.20±2.26, P〈 0.01）. With MoCA, LA group showed lower scores than those of the control group in naming, language, abstraction and orientation （P 〈 0.01）. The total scores of MMSE in I.A group（27.54± 1.36）were obviously lower than those in the control group（28.06± 1.92, P 〈 0.05）. With MMSE, LA group showed lower scores than those of the control group in orientation and delayed memory （P 〈 0.05）. In I.A group, MoCA diagnosed the sensitivity of VCI was 93.90%, the specificity was 63.6 G, the false positive rate was 36.4%, the false negative rate was 9.1 % the post rive predictive value was 91.3G, the negative predictive value was 70.0%, the diagnostic accordance rate was 84.2%, and the Youden index was 0. 569. The above indicators of MMSE diagnosed VCI were 26.7%,90.9%,6.7%,73.3%,92.3%,23.3%,43.4%, and0.176, respectively. Conclusions The pa tients with I.A exist cognitive dysfunction, especially in naming, language, abstraction, orientation and delayed memory. MoCA may be a better measure to evaluate the cognitive dysfunction in patients with LA.