MMSE、HIS、ADL在阿尔茨海默病筛查中的应用

Evaluation of MMSE,HIS,ADL in AD screening

目的评价简易智能量表(MMSE)、Hachinski缺血指数量表(HIS)、日常生活功能量表(ADL)3种量表在阿尔茨海默病(Alzheimer’sdisease,AD)早期筛查中的应用价值。方法对56例50岁以上AD高风险人群进行MMSE、HIS、ADL测试,比较3种量表在AD筛查中的有效性及优缺点。结果在AD组和非AD组之间,MMSE和ADL得分有显著性差异,HIS得分无差异性。MMSE、HIS、ADL3组量表敏感性分别为92·86%、100%、89·28%,特异性分别为85·71%、42·86%、60·71%,准确性分别为89·28%、71·43%、75·00%。结论3组量表中MMSE敏感性、特异性和准确性均较好,HIS敏感性最高但特异性最低,ADL敏感性接近于MMSE但特异性稍低。MMSE适合于老年高风险人群的AD筛查,HIS和ADL必须考虑到筛查对象的具体流行病学特点配合MMSE进行AD筛查。

Objective: To find the advantages and disadvantages of the collaboration of three mini scales- MMSE,HIS,ADL. Methods: 56 in-and out-patients above 50 years old who have a high risk of AD were recruited. MMSE,HIS and ADL were adopted to all the subjects. Additionally, the availability of these mini scales were estimated objectively. Results: The scores of MMSE and ADL were significantly different between AD non-AD patients while the score of HIS was not. The sensitivities of MMSE, HIS and ADL were 92.86%,100%,89.28% respectively, specificities 85.71%,42.86%,60.71%, and accuracies 89.28%,71.43%,75.00%. Conclusion: MMSE is sensitive, specific and accurate to the diagnosis of AD. HIS is the most sensitive but not specific. The sensitivity of ADL is close to MMSE, however, its specificity is not better. MMSE is suitable to the old with a high risk of AD in screening. HIS and ADL should account to the epidemical features of samples and cooperate with MMSE in large-populated samples for the screening of AD.