不同间期测量术后认知功能变化的重测信度分析

Analysis of test-retest reliability in assessing postoperative cognitive function change with neuropsychological tests at different interval period

目的探讨不同间期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。分别对入选对象做三次认知功能神经心理学测定,第一次测定(T1)作为基础值,第二次测定(T2)和第三次测定(T3)分别与第一次测定间隔3天和30天。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虽然具有一定的重测学习效应,但不同间隔时间对重测信度较好的神经心理学测验的重测稳定性影响不大。

Objective To investigate the dependability and stability in assessing postoperative cognitive function change with neuropsychological tests at different interval period.Methods After Research Ethics Board approval and informed consent,30 healthy volunteers（18-52 years old） were recruited and administered with six neuropsychological tests form the Wechsler Adult Intelligence Scale on three occasions： the first measurement（T1,as baseline）,3 day（T2） and 30 day（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 assess 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（P0.05）.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.However,the different interval time cannot effect the dependability and stability of neuropsychological tests with better test-retest reliability.