蒙特利尔认知评估量表在非痴呆性血管性认知功能障碍患者应用价值研究

目的:评价简易精神状态量表(MMSE)相比蒙特利尔认知评估量表(MoCA)在非痴呆性血管性认知功能障碍(VCIND)患者中的特点及早期发现VCIND的价值。方法:对120例VCIND患者和50例无认知功能障碍(NCI)脑梗死恢复期患者进行一般检查、神经功能评定检查,根据MMSE和MoCA评分程度将受试者分成NCI组50例、轻度VCIND组44例及重度VCIND组76例。比较3组MoCA和MMSE各项评分。结果:轻度VCIND组MoCA子项中视空间与执行功能、注意、语言、抽象、延迟记忆、定向及MMSE子项中回忆和定向评分均低于NCI组(P<0.05~P<0.01),重度VCIND组MoCA全部子项及MMSE子项执行功能、计算、回忆和定向评分均低于NCI组(P<0.01),重度VCIND组MoCA子项视空间与执行功能、注意、语言、延迟记忆、定向评分及MMSE子项中执行功能、回忆和定向评分均低于轻度VCIND组(P<0.05~P<0.01)。结论:MoCA在早期发现VCIND优于MMSE,对预测预后可能有一定的作用。

Montreal cognitive assessment for detection of patients with vascular cognitive impairment,no dementia

Objective:To evaluate Montreal cognitive assessment ( MoCA ) and mini-mental state examination ( MMSE ) in early detection of patients with vascular cognitive impairment,no dementia( VCIND) . Methods:One hundred and twenty patients with VCIND and 50 cases with no cognitive impairment ( NCI ) after stroke were performed laboratory examinations and neuropsychological assessments. All the subjects were divided into NCI group 50 cases,mild VCIND group 44 cases and severe VCIND group 76 cases according to the results of MMSE and MoCA;the scores were compared among the three groups. Results:The MoCA domain subtest scores(visuospatial/executive,attention,language,abstraction,delayed recall and orientation) and the MMSE domain subtest scores (delayed recall and orientation) in the mild VCIND group were significantly lower than those in the NCI group(P <0. 05 to P <0. 01);all the MoCA domain subtest scores and the MMSE domain subtest score ( executive, computation, delayed recall and orientation) in the severe VCIND group were lower than those in the NCI group ( P <0. 01 );the MoCA domain subtest scores (visuospatial/executive,attention,language,delayed recall and orientation) and the MMSE domain subtest score(executive,delayed recall and orientation) in the severe VCIND group were lower than those in the mild VCIND group(P <0. 05 to P <0. 01). Conclusions:MoCA is superior to MMSE in early detection of VCIND and may help to predict the prognosis.