蒙特利尔认知量表对短暂性脑缺血发作患者轻微认知功能障碍的诊断价值

The value of montreal cognitive assessment in evaluation of mild cognitive impairment in patients with transient ischemic attack

目的:探讨蒙特利尔认知评估量表(MoCA)对短暂性脑缺血发作(TIA)患者轻微认知功能障碍(MCI)的诊断价值。方法:将76例TIA患者分为有MCI组(A组)和无MCI组(B组),检测MoCA及事件相关电位(P300),并与38例健康体检人员(C组)进行比较。结果:A组MoCA总分19.51±3.96,P300潜伏期(367.05±36.03)ms,与B组及C组差异均有显著性(均P<0.01)。绘制工作特征曲线,MoCA曲线下面积为0.935(95%可信区间0.879～0.992)。MoCA评估TIA患者有无MCI以最大约登指数所对应的分值为截断点,截断值为25分,与临床金标准诊断结果符合率高,Kappa值为0.698,敏感性和特异性为85.45%和90.48%,诊断效率优于P300潜伏期。结论:MoCA筛查TIA患者轻微认知功能障碍的截断值为25分,MoCA可以作为TIA患者认知功能受损筛查的良好工具。

Objective To explore the value of montreal cognitive assessment （MoCA） in evaluation of mild cognitive impairment（MCI）in patients with transient ischemic attack （TIA）.Methods Seventy-six patients with TIA were divided into patients with MIC group （group A） or patients without MIC group （group B）.Thirty-eight healthy individuals were as control （group C）.Results The scores of MoCA （19.51 ± 3.96） and the latency period of P300（367.05 ± 36.03ms）in group A were significantly higher than group B and group C （P 0.01）.The area under ROC curve of MoCA was 0.935 （95% credible interval 0.879 ～ 0.992）.Score of optimal cut-off-point of the MoCA in evaluating TIA patients was 25 in ROC curve analyses as well as the largest Youdens index？ which accords with the diagnosis by clinical golden standard.Kappa value was 0.698.Sensitivity and specificity were found to be 85.45% and 90.48% respectively.Efficiency of MoCA for the diagnosis of TIA patients with cognitive impairment was superior to that of latency period of P300.Conclusion The score of optimal cut-off-point of MoCA was 25.in screening MCI.MoCA could be a good tool in screening MCI from the patients with TIA.