威斯康星卡片分类测验用于颅脑损伤者认知功能障碍鉴定

Evaluating on Recognition Impairment after Traumatic Brain Injury with WCST

目的探讨威斯康星卡片分类测验(Wisconsin Card Sorting Test,WCST)对颅脑损伤者认知功能障碍鉴定的应用价值。方法对186例颅脑外伤要求鉴定的患者(实验组)和180例健康志愿者(对照组)分别进行WCST和中国修订版韦氏成人智力量表(Wechsler Adult Intelligence Scale Revised in China,WAIS-RC)测验,比较两组的测验结果。将WCST各项指标与智商进行相关性分析,并分析年龄、文化程度及脑损伤程度与执行功能的关系。结果 (1)实验组的智商和WCST成绩均低于对照组(P<0.05);(2)相关性分析表明WCST中错误应答数、持续性错误百分数、随机错误百分数、完成第一个分类所需应答数与智商呈负相关(P<0.05);完成分类数及概念化水平百分数与智商呈正相关(P<0.05);(3)脑外伤严重程度与概念化水平百分数呈负相关,与持续性错误百分数、随机错误百分数、完成第一个分类所需应答数呈正相关(P<0.05)。结论颅脑损伤鉴定中,WCST可以用作评估认知的重要方法。

Objective To explore the value of Wisconsin Card Sorting Test（WCST） in evaluating the recognition impairment after traumatic brain injury（TBI）.Methods WCST and Wechsler Adult Intelligence Scale Revised in China（WAIS-RC） were adopted to assess the cognitive function in 186 patients with brain injury（experimental group） and 180 healthy volunteers（control group）,respectively.The cognition between the experimental group and the control group was compared.The correlation between WCST and IQ was analyzed.The correlation between age,education level,the severity of TBI and the executive function were also analyzed.Results（1） The performances of WAIS-RC and WCST in the experimental group were significantly worse than that of the control group.（2） There were significantly negative correlation between the performance of total errors,percentage of preservative errors,percentage of random errors,response number on first category and IQ（P0.05）.While there were significantly positive correlation between the categories completed,percentage of conceptual level and IQ（P0.05）.（3） There was significantly negative correlation between percentage of conceptual level and the severity of TBI.While there were significantly positive correlation between percentage of preservative errors,percentage of random errors,response number on first category and the severity of TBI.Conclusion WCST could be an important method in evaluating cognition of patients with brain injury.