比较简易精神状态量表与蒙特利尔认知评估量表在腔隙性脑梗死认知障碍患者中的应用价值

Comparison of the Application Value of Mini-mental State Examination and Montreal Cognitive Assessment in Lacunar Infarction Patients with Cognitive Impairment

目的比较简易精神状态(MMSE)量表与蒙特利尔认知评估(MoCA)量表(中文版)在腔隙性脑梗死患者认知障碍评估中的应用价值。方法首先采用中文版MMSE量表对确诊为腔隙性脑梗死的患者进行筛选,然后对经过受教育程度矫正后MMSE得分正常的患者采用中文版MoCA量表进行评分。MoCA<26分者纳入腔隙性脑梗死认知功能障碍(LI-CI)组,MoCA≥26分者纳入腔隙性脑梗死认知功能正常(LI-NC)组,另选50例健康体检者作为对照(NC)组。比较3组患者MoCA总分及各个认知领域的得分情况。结果 MMSE得分正常的患者中有53%(50/94)MoCA评分<26分,其认知功能与MoCA评分≥26分的患者比较,差异有统计学意义﹙P<0.01﹚。LI-CI组在视空间与执行能力、命名、延迟记忆、抽象等认知领域得分低于LI-NC组(P<0.05)。结论 MMSE评分正常、MoCA评测异常的患者认知损害主要表现在视空间与执行功能、命名、延迟记忆、抽象等方面。MoCA量表在筛查腔隙性脑梗死患者认知障碍方面可能比MMSE量表更敏感。

Objective To compare the application value of mini-mental state examination （MMSE） and Montreal cognitive assessment （MoCA） in detecting cognitive impairment in lacunar infarction （LI） patients. Methods The LI patients were first screened by MMSE, and those having a normal education-adjusted score were further assessed by MoCA （26 as the cut-off score）. The patients with MoCA score less than 26 were selected into cognitive impaired LI-CI group and the patients with more than 26 were classified as normal control LI-NC group. Fifty healthy individuals were recruited in the healthy control group （NC group）. The total score and the score of each cognitive field of Mo- CA among three groups was compared and analyzed. Results 53% （50/94） LI patients with normal MMSE had MoCA 〈 26. There was a statistical significant difference （P 〈 0.01） of the cognitive function between these cases and patients with MoCA I〉 26. The MoCA score of LI-CI group was less than LI-NC group in visuospatial, executive, naming, delayed recall, abstraction and so on. The differences were statisti- cal significant （P 〈 0.05）. Conclusion The cognitive impairment of those patients with normal MMSE score but abnormal MoCA score were mainly in visuospatial, executive, naming, delayed recall, abstraction and so on. MoCA is more sensitive than MMSE in cognitive impair- ment screening in LI patients.