不同神经心理学测验评估术后认知功能变化的重测信度分析

Analysis of test-retest reliability of different neuropsychological tests in assessing postoperative cognitive function change

目的探讨不同神经心理学测验在评估术后认知功能变化中的稳定性和可靠性。方法选择年龄18￣55岁的健康志愿者30人为研究对象。分别对入选对象做3次认知功能神经心理学测定,第1次测定(T1)作为基础值,第2次测定(T2)和第3次测定(T3)分别与第1次测定间隔3d和30d。认知功能测验包括累加、视觉再认、联想学习、算术、数字广度和数字符号6项测验。以Pearson相关系数r值评价重测信度,r值越接近于1,表明重测信度越高。结果 T2和T3时的各项认知功能测验值普遍高于T1测验值。累加、视觉再认和联想学习的r值较小且变化幅度较大,算术、数字广度和数字符号的重测相关系数均大于0.75,且在不同间隔时间的r值波动较小。结论神经心理学测验具有一定的重测学习效应。算术、数字广度和数字符号的重测信度较高,累加的重测信度中等,而联想学习和再认测验的重测信度较差。

【Objective】To investigate the dependability and stability of different neuropsychological tests in assessing postoperative cognitive function change.【Methods】After approval of Research Ethics Board and informed consent,30 healthy volunteers （18~52 years old） were recruited and administered with six neuropsychological tests form the China Recension Wechsler Adult Intelligence Scale and China Recension Wechsler Adult Memory Scale on three occasions： the first measurement （T1,as baseline）,3 days （T2） and 30 days （T3） after the first measurement.On each occasion,a parallel version of the test battery was given to reduce learning effects.The test-retest reliability of neuropsychological test variables was assessed by Pearson correlation coefficient r value.【Results】Most of test scores at the second and the third occasions were higher generally and significantly than test scores at the first occasion （P 0.05）,The r value of the paired associate verbal learning test and visual recognizing were lower and instable at different interval,the continuative adding’s was between 0.576 and 0.772,however,the r value of arithmetic,digit span and digit symbol were higher than 0.75 and stable at each interval.【Conclusion】The neuropsychological tests have learning effects when administered repeat.The test-retest reliability of arithmetic,digit span and digit symbol are excellent,the continuative adding’s is moderate and the others are not good.