蒙特利尔量表对老年慢性阻塞性肺疾病患者认知功能的评估

目的分析慢性阻塞性肺疾病（COPD）患者认知功能的改变,并探讨蒙特利尔（MoCA）量表和简明智能精神状态检查量表（MMSE）在评估认知功能方面的差异。方法分别采用MoCA、MMSE量表评估41例COPD患者和47例对照者认知功能的改变,并对2组MoCA、MMSE量表测量结果的特异度、灵敏度及一致性进行分析,进一步比较2种量表评估COPD伴轻度认知功能障碍（MCI）患者认知能力的差异。结果 COPD组MoCA总评分、MMSE总评分分别为（19.2±8.1）分及（22.6±8.4）分,低于对照组的（23.5±4.8）分及（26.9±5.0）分,在COPD人群中,MoCA量表诊断MCI的灵敏度为100%,特异度为76.9%,Kappa值为0.769;MMSE量表诊断MCI的灵敏度为53.8%,特异度为100%,Kappa值为0.538,MoCA量表对MCI的诊断效力明显高于MMSE。结论COPD患者存在认知功能损害,表现在记忆、注意力、计算、定向、语言等多个领域的认知障碍,MoCA和MMSE联合应用有利于早期发现COPD患者的认知功能障碍,对于MCI患者,MoCA较MMSE量表更为灵敏。

Assessment of the cognitive functions of the elderly patients with chronic obstructive pulmonary disease using Montreal cognitive scale

Objective To analyze the cognitive function of the elderly patients with chronic obstructive pulmonary disease （COPD） using Montreal cognitive （MoCA） scale and mini-mental state examination （MMSE） scale,and to investigate the differences between MoCA and MMSE. Methods MoCA scale and MMSE scale were used to assess the cognitive function of 41 elderly patients with COPD and 47 normal controls. The specificity, sensitivity and consistency of measurement results of MoCA scale and MMSE scale were analyzed. Furthermore, the difference between MoCA scale and MMSE scale in assessing the cognitive functions of the elderly patients with COPD complicated with mild cognitive impairment（MCI） was analyzed. Results The scores of MoCA scale and MMSE scale in COPD group was 19. 2±8.1 and 22. 6 ±8.4, compared with 23.5±4. 8 and 26. 9±5.0 in normal control group（P〈0. 05）. In COPD patients, the sensitivity rate of MoCA scale was 100%, the specificity rate was 76. 9% and the Kappa value was 0. 769. While the sensitivity rate of MMSE was 53.8%, the specificity rate was 100% and the Kappa value was 0. 538. Conclusions COPD induces the impairment of cognitive functions in memory, concentration, computing, directions determine and language expression. The combination of MoCA scale and MMSE scale could help to find out the damages of cognitive functions in the patients with COPD as early as possible. Besides, MoCA scale is more sensitive and more appropriable than MMSE scale on patients who are present with MCI.