蒙特利尔认知评估量表对脑梗死患者认知功能障碍评估的初步临床研究

目的观察中文版蒙特利尔认知评估量表(Montreal Cognitive Assessment Scale,MoCA)对脑梗死患者认知功能障碍的评定效果,并对其标准效度进行检验。方法应用简易智能状态检查量表(Mini-Mental State Examination,MMSE)和MoCA分别对60例脑梗死患者(脑梗死组)和60例周围神经系统疾病患者(对照组)进行认知功能评定,脑梗死组患者给予对应治疗,并于1个月后再次进行MMSE和MoCA评定。结果对照组和脑梗死组患者治疗前后MoCA与MMSE总分均具有较好相关性(r=0.921,r=0.916,r=0.899,P0.01)。脑梗死组患者治疗前后MoCA各条目得分及总分较对照组均明显降低,差异有统计学意义(P0.05),但脑梗死组患者治疗后1个月,除延迟记忆外,较治疗前MoCA各条目得分及总分明显提高,差异有统计学意义(P0.05)。脑梗死组患者治疗前MoCA评分异常率明显高于MMSE评分异常率,差异有统计学意义(x~2=5.63,P0.05)。结论MoCA在临床中筛查脑梗死后的认知功能障碍具有可靠的标准效度,亦能灵敏的判断出认知功能改善状况,与MMSE比较,MoCA用于此类患者评定所得出的异常率可能更高。

Clinical study of cognition assessment by MoCA in the patients with cerebral infarction

Objective To observe the efficacy of the Chinese version of Montreal Cognitive Assessment Scale(MoCA) in cognition assessment in the patients with cerebral infarction and to evaluate its standard validity.Methods Sixty patients with cerebral infarction (stroke group) and 60 patients with diseases of peripheral nerves (control group) received the cognitive assessment by Mini-Mental State Examination(MMSE) and MoCA.In the stroke group,the cognitive assessment was performed again after one month of treatment.Results There was high correlation between the total scores of MMSE and MoCA in both groups before and after treatment (r = 0.921,r = 0.916,r = 0.899,P< 0.01),and there was significant difference in the MoCA scores between the two groups (P < 0.05).Compared with before treatment,the score of MoCA in the stroke group after treatment was higher except the item of delayed recall (P < 0.05).In the stroke group,the rate of abnormal cognition assessment score by MoCA was higher than that by MMSE (x~2= 5.63,P < 0.05).Conclusion The MoCA can effectively assess cognitive impairment and improvement with satisfactory standard validity in the patients with cerebral infarction. Compared with MMSE,the MoCA is a more sensitive screening tool for cognitive impairment in cerebral infarction.