简易精神状态量表和蒙特利尔认知评测量表对急性期缺血性脑血管病患者认知功能障碍筛查能力的比较研究

目的比较简易精神状态量表(Mini-Mental State Examination,MMSE)和蒙特利尔认知评测量表(Montreal Cognitive Assessment,MoCA)对急性期缺血性脑血管病患者认知功能障碍的筛查能力。方法对筛选的107例发病7 d内的短暂性脑缺血发作(transient ischemic attack,TIA)或脑梗死患者应用MMSE及MoCA量表进行认知功能障碍的评测,比较经两量表评测筛查出认知障碍患者的比例。根据患者教育程度对应的MMSEI临界值筛选出MMSE评分在正常范围的患者,以MoCA量表评分26分为临界值将受试者分为MoCA评测正常组与异常组,比较两组在各个认知领域的得分。结果 107例患者MMSE平均分25.89±3.65分,MoCA平均分20.67±4.56分。MMSE评测异常者8例(7.5%),正常者99例(92.5%)。MoCA评测异常者98例(91.6%),正常者9例(8.4%)。MoCA评测正常者MMSE评测均正常。MMSE评测正常的99例患者中,MoCA评测正常者9例(9.1%,9/99),评测异常者(26分)90例(90.9%,90/99)。MoCA评测异常组在视空间与执行能力、命名、延迟记忆等认知领域得分低于MoCA评测正常组(P0.05)。结论 MoCA量表在筛查急性缺血性脑血管病患者认知障碍方面可能比MMSE量表更敏感,MMSE正常MoCA评测异常的患者认知损害主要表现在视空间执行功能、命名、延迟记忆等方面。

Screening of Cognitive Impairment in Patients with Ischemic Cerebrovascular Disease with Mini-Mental State Examination and Montreal Cognitive Assessment Scale

Objective To compare the ability of Mini-Mental State Examination （MMSE） and Montreal Cognitive Assessment （MoCA） in screening cognitive impairment in patients with transient ischemic attack （TIA） and acute ischemic stroke. Methods The cognitive function of patients （n-107） with TIA and acute ischemic stroke （onset within 7 days） was assessed with MMSE and MoCA. Only subjects （n=99） defined as having a normal age-and education-adjusted MMSE were then divided into two groups according to the cut-off point of 26. The performance of cognitive domain was compared between the 2 groups （MoCA〈26 group VS MoCA〉26 group）. Results The mean MMSE and MoCA scores standard deviation were 25.89±3.65 and 20.67±4.56 respectively; 8 patients （7.5%, 8/107） got abnormal MMSE score, and 98 patients＇ MoCA score was abnormal （91.6%, 98/107）. Ninety subjects got normal MMSE but abnormal MoCA score and the patients with normal MoCA score all had normal MMSE score. The patients with abnormal MoCA had lower scores in several cognitive domains （visuospatial and executive abilities, naming, delayed memory, P〈0.05） compared with control group. Conclusion The MoCA is a more sensitive screening instrument than the MMSE for cognitive impairment in patients with TIA and acute ischemic stroke. Visuospatial and executive abilities, naming, delayed memory domains were impaired in acute ischemic stroke patients with normalMMSE but abnormal MoCA score.