国内常用三分法画钟测验在阿尔茨海默病和血管性痴呆中的鉴别作用

Function of Three-point Scoring System for the Clock Drawing Test in Differentiating between Alzheimer's Disease and Vascular dementia in China

目的探讨3分法画钟测验(clock drawing test,CDT)对阿尔茨海默病患者(Alzheimer disease,AD)与血管性痴呆患者(vascular dementia,VD)的鉴别作用。方法收集四川大学华西医院神经内科门诊及住院部2009年9月-2010年6月就诊的认知功能障碍患者150例,进行病史采集及神经心理测试量表,筛选出AD患者57例及VD患者43例,共计纳入100例。在两者间进行CDT,分析两者间CDT有无差别、CDT与中文版简易智能量表(Chineseversion of the mini-mental state examination,MMSE)及临床痴呆评定量表(clinical dementia rating scale,CDR)的相关性。结果 AD患者及VD患者间CDT差异无统计学意义(P>0.05);CDT与MMSE及CDR有相关性,Spearman相关系数分别为0.573和-0.542(P<0.001)。结论 3分法画钟测验无法准确区分AD和VD,但对粗略判断AD及VD程度可能有一定效果。

Objective To investigate the differential function of the three-point scoring system for the clock drawing test（CDT） between Alzheimer＇s disease（AD） and vascular dementia（VD）.Methods We analyzed the clinical data of 150 patients with cognitive impairment treated in the neurology and inpatient departments of our hospital from September 2009 to July 2010.Medical history of the subjects were collected.Through the assessment by neurological and psychological rating scale,we picked out 57 patients with AD and 43 with VD and tested them with CDT.The difference of CDT results between the two groups,and the correlation of CDT with Chinese version of the mini-mental state examination（MMSE） and clinical dementia rating scale（CDR） were analyzed.Results There was no statistical difference of CDT results between AD and VD patients（P0.005）.CDT had a correlations with MMSE and CDR,the Spearman correlation coefficient being 0.573 and-0.542 respectively（P0.001）.Conclusion The three-point scoring system for the clock drawing test cannot differentiate exactly between Alzheimer Disease and Vascular Dementia,but it can make a gross judgment of the degree of AD and VD.