蒙特利尔认知评估量表对腔隙性脑梗死患者认知功能障碍的评估价值研究

目的探讨蒙特利尔认知评估量表(Montreal Cognitive Assessment,MoCA)(中文版)在腔隙性脑梗死患者认知功能障碍评估中的应用价值。方法首先采用中文版简易智能状态量表(Mini-Mental State Examination,MMSE)对确诊为腔隙性脑梗死患者进行筛选,然后对经过受教育程度矫正后MMSE得分正常的患者采用中文版MoCA进行评分,使用26分作为分界值。MoCA<26分者纳入腔隙性脑梗死认知功能障碍组(LI-CI组),MoCA≥26分者纳入腔隙性脑梗死认知功能正常组(LI-NC组)。比较两组患者MoCA评分、MMSE评分及MoCA各个认知领域得分情况。结果 MMSE得分正常的患者有53%(50/94)MoCA评分<26分,这些患者的认知功能与MoCA评分≥26分的患者比较,差异有统计学意义﹙P<0.01﹚;LI-CI组在视空间功能与执行功能、命名、抽象、延迟回忆认知领域方面得分低于LI-NC组,差异均有统计学意义(P<0.05)。结论 MoCA在筛查腔隙性脑梗死患者认知障碍方面可能比MMSE更为敏感,对于MMSE评分正常MoCA评测异常的患者认知损害主要表现在视空间与执行功能、命名、延迟记忆以及抽象等方面。

Application Value of Montreal Cognitive Assessment in Lacunar Infarction Patients with Cognitive Impairment

Objective To analyze the application value of Montreal Cognitive Assessment(MoCA)(Chinese version) in detecting cognitive impairment in patients with lacunar infarction(LI).Methods The patients confirmed with LI were first screened by Mini-Mental State Examination(MMSE),and patients having normal MMSE score were further assessed by MoCA after education adjustment(26 as the cut-off score).The patients with MoCA score less than 26 were selected as cognitive impaired LI-CI group and the patients with more than 26 were selected as normal control LI-NC group.MoCA score,MMSE score and scores of each cognitive field of MoCA were compared between the two groups.Results 53%(50/94) LI patients with normal MMSE score had MoCA socre<26,and these patients′ cognitive function showed statistically significant difference with the patients who had MoCA socre≥26(P<0.01).The scores of visuospatial and executive function,naming,Abstract and delayed recall of the LI-CI group showed statistically significant differences with those of the LI-NC group(P<0.05).Conclusion MoCA is more sensitive than MMSE in screening cognitive impairment in LI patients.The cognitive impairments of patients with normal MMSE but abnormal MoCA are mainly visuospatial and executive function,naming,delayed recall,Abstract and so on.