画钟试验和画钟时长在轻度认知功能障碍诊断中的应用

目的探讨画钟试验和画钟时长在轻度认知功能障碍（mild cognitive impairment，MCI）诊断中的应用价值。 方法选取2015年12月至2016年12月就诊于浙江医院进行认知功能评估调查的104例MCI患者（MCI组）和188例健康老年人（对照组），均行简易神经心理量表（mini-mental state examination，MMSE）和画钟试验评估。比较两组对象画钟试验得分以及各组中得分满分者画钟时长的差异，并分析画钟试验诊断MCI的敏感性和特异性。 结果两组对象MMSE得分的差异无统计学意义（t=1.907，P>0.05）。MCI组画钟试验得分显著低于对照组（t=3.190，P<0.01）。对照组画钟试验不同得分分布情况明显优于MCI组（z=8.171，P<0.01）。MCI组画钟时长显著长于对照组（t=2.941，P<0.01）。以画钟试验得分≤3分进行MCI诊断的敏感度为38.46%，特异度为76.60%；以得分≤4分进行诊断的敏感度为52.88%，特异度为61.70%。 结论画钟试验一定程度上有助于鉴别诊断MCI和健康人群，而且MCI患者画钟时长明显长于健康人群。

Application of clock drawing test and its time consume in the diagnosis of mild cognitive impairment

ObjectiveTo investigate the value of clock drawing test (CDT) and the time consumed in CDT in the diagnosis of mild cognitive impairment (MCI). MethodsPatients with mild cognitive impairment (MCI group, n=104) and healthy controls (control group, n=188) who were admitted to Zhejiang hospital from December 2015 to December 2016 were selected and underwent neuropsychological examination, including Mini-mental state examination (MMSE) and CDT. The score of CDT and the time consume in correct clock drawing between two groups were compared. The sensitivity and specificity of CDT in diagnosing MCI were also analyzed. ResultsThere was no significant difference in MMSE scores in two groups (t=1.907, P>0.05), while the CDT scores of MCI group were significantly lower than that of the control group (t=3.190, P<0.01). The distribution of higher scores in the MCI group was significantly worse than that in control group (z=8.171, P<0.01). The time consumed in MCI group was significantly longer than that in control group (t=2.941, P<0.01). At a cutoff of ≤3, the CDT had a sensitivity of 38.46% and specificity of 76.60%; at a cutoff of ≤4, the CDT had a sensitivity of 52.88% and specificity of 61.70%. ConclusionCDT and its time consume are helpful to differentiate MCI from healthy control.