136例获得性免疫缺陷综合征患者神经认知功能障碍的研究

Occurrence of neurocognitive disorders in 136 acquired immunodeficiency syndrome patients in Shanghai

目的:评估上海市获得性免疫缺陷综合征(AIDS)门诊患者中人类免疫缺陷病毒(HIV)相关认知功能损害(HAND)的发生情况。方法:对2012年12月1日至31日在上海市公共卫生临床中心就诊的门诊患者进行横断面的研究。收集患者性别、年龄、受教育程度以及抗反转录病毒治疗(ART)等情况。用蒙特利尔认知功能评估量表(MoCA)、日常生活活动(ADL)量表以及认知筛查问题等对患者的认知功能进行评估。结果:MoCA评分正常和异常的患者分别为71例(52.2%)和65例(47.8%),在性别方面没有显著性差异(P=0.004)。MoCA评分异常组中年龄以及文化程度低的患者比例显著升高(均P<0.001),而是否ART对其并无影响(P=0.672)。MoCA评分异常的患者更易出现ADL评分异常以及筛查问题答案异常。结论:上海市AIDS患者通过认知功能的初筛工具发现异常的比例较高。MoCA可以作为HAND的筛查工具。

Objective The occurrence of human immunodeficiency virus（HIV）-related cognitive impairments was evaluated in Shanghai HIV positive outpatients.Methods A cross-sectional analysis of 136 HIV positive outpatients in Shanghai Public Health Clinical Center（China） from December 1st 2012 to December 31st 2012 was performed.Interview data,sex,age,education level,and anti-retroviral treatment（ART） were recorded.Cognitive function was evaluated by Montreal cognitive assessment（MoCA）,activities of daily living（ADL）,and screening of cognitive questions by questionnaire.Results Normal and abnormal MoCA score were detected in 71（52.2%） and 65（47.8%） patients,respectively.No significant difference was found between male and female patients（P=0.004）.Abnormal MoCA score was more frequent in younger patients（P0.001） and patients with lower education level（P0.001）,and was not affected by ART（P =0.672）.Patients with abnormal MoCA score more likely had abnormal ADL score and answer of screening questions.Conclusions A high rate of abnormal congnitive function in AIDS patients in Shanghai was detected by these screening tools.MoCA could be used as a screening tool for HIV associated neurocognitive disorder.