蒙特利尔认知评估量表在评估慢性酒精中毒致认知损害的应用与相关临床因素分析

Application of Montreal cognitive assessment in evaluating alcoholism-induced cognitive impairment and analyses of associated clinical parameters

目的探讨蒙特利尔认知评估量表在临床评估慢性酒精中毒致认知损害的应用,并对相关临床因素进行分析。方法采用蒙特利尔认知评估量表(MoCA)中文版对慢性酒精中毒致认知功能损害进行评估,并对临床检测指标脑电、影像学-CT检测大脑海马体积与脑室颞角宽度等相关因素分组进行相关性分析。结果慢性酒精中毒患者使用MoCA检测认知功能障碍检出率达93%。相关性分析显示慢性酒精中毒组MoCA评分与饮酒年限呈正相关(r=0.368,P<0.01);MoCA评分与脑电图异常程度呈正相关(r=0.215,P<0.05);左右海马体积与MoCA测定值呈正相关(r=0.403,P<0.01),左右侧脑室颞角宽度与MoCA测定值呈负相关(r=-0.351,P<0.01)。结论蒙特利尔认知评估量表评分与慢性酒精中毒患者的电生理和影像异常改变有明显相关性,蒙特利尔认知评估量表应用于慢性酒精中毒患者早期认知评估有一定实用价值。

Objective To assess the cognitive impairment induced by alcohol dependence with Montreal cognitive assessment（MoCA） ,and to analyze related clinical factors. Methods Montreal cognitive assessment（ MoCA,Chinese version）was applied to evaluate the cognitive impairment of patients with alcohol dependence. Clinical parameters including electroencephalography（EEG） ,hippocampal volume and width of the temporal horns measured with CT scans were grouped for comparative analysis with cognitive evaluation. Result The positive rate of cognitive impairment, assessed with MoCA, of patients with alcohol dependence was 93%. Correlation study indicated that in alcohol dependence group, MoCA scores of patients were positively correlated with years of alcohol intake （ r = 0.368, P 〈 0.01 ） , degree of abnormalities in EEG（ r = 0. 215 ,P 〈 0.05 ） and hippocampal volume （ r = 0. 403, P〈 0.01 ） , while negatively correlated with width of the temporal horns（r=-0. 351 ,P 〈 0.01 ）. Conclusion The scores of Montreal cognitive assessment of alcohol dependent patients with cognitive impairment apparently correlates with abnormal electrophysiological and radiographic changes observed. MoCA may have practical value for early assessment of cognitive function of patients with alcohol dependence.