蒙特利尔认知评估量表在短暂性脑缺血发作患者认知功能筛查中的应用

目的 探讨蒙特利尔认知评估量表(Montreal Cognitive Assessment,MoCA)对短暂性脑缺血发作(transient ischemic attack,TIA)患者认知功能损害评估的意义.方法 选择61例临床诊断为TIA的患者,在其最后一次发作的72h内应用MoCA及简易智力状态量表(Mini-mental State Examination,MMSE)检测其认知功能,与40例健康体检人员进行对照比较.结果 TIA组的MoCA总评分、MMSE总评分[分别为(16.59±5.74)分,(20.80±4.20)分]低于健康体检对照组[分别为(27.58±1.36)分,(27.69±2.00)分],差异具有显著性(P＜0.01);TIA患者的MoCA和MMSE总评分随TIA发作次数增加而降低,TIA患者的MoCA总评分与MMSE总评分呈显著性正相关(r=0.777,P＜0.01),且相关系数随发作次数增加而增高;MoCA对TIA认知障碍诊断的敏感性、诊断效率(分别为86.89%、90.10%)高于MMSE(分别为67.21%、79.21%),差异具有显著性(P=0.010、P=0.032).结论 MoCA量表测试可以反映TIA认知功能损害的临床特征,可作为TIA患者认知功能受损筛查的良好工具,其应用价值优于MMSE.

The clinical application of Montreal cognitive assessment in patients with transient ischemic attack

Objective To evaluate the clinical significance of Montreal cognitive assessment(MoCA)in detecting cognitive impairment in patients with transient ischemie attack(TIA).Methods Sixty-one patients with transient iscbemie attack in seventy-two hours and forty healthy individuals were assessed with MoCA and Minimental State Examination.Results The MoCA scores(16.59±5.74)and MMSE scores(20.80±4.20)of the TIA group were obviously lower than that of the control group(27.58±1.36,27.69±2.00,respectively P＜0.01).With the increase of attack times,the MoCA scores and MMSE scores decreased gradually.The correlation analysis indicated that there was a positive correlation between MoCA and MMSE in patients with TIA(r=0.777,P ＜0.01).With the increase of the frequency of attack,the correlation coefficient advanced gradually.The sensitivity(86.89%)and diagnostic effect(90.10%)of MoCA were obviously higher than that of MMSE(P=0.010,P=0.032,respectively)in TIA diagnosis.Conclusion The TIA patients exist cognitive dysfunction,and MoCA may be a better measure to evaluate the cognitive dysfunction in patients with TIA than MMSE.