MoCA和MMSE在HIV相关性神经认知损害筛查中的比较

Comparison of Montreal cognitive assessment scale and minimental state examination scale in screening HIV-associated neurocognitive disorders in Shenzhen, China

目的 比较蒙特利尔认知评估量表（MoCA）和简易精神状态量表（MMSE）在筛查HIV相关性神经认知障碍（HAND）中的能力.方法 用MoCA量表和MMSE量表对门诊127例HIV/AIDS患者及60例健康对照进行测试,并对测试结果进行比较和统计分析.结果 MoCA量表得分在HIV ＋/AIDS组（26.28 ±2.43分）和HIV-对照组（27.33±1.30分）之间差异有统计学意义（P＜0.01）.MMSE量表得分在HIV ＋/AIDS组（27.45 ±1.31分）和对照组（27.70±0.89分）之间没有统计学差别（P=0.139）.使用MoCA量表,HIV ＋/AIDS组的HAND患病率明显大于对照组（x2=16.01,P＜0.001）.使用MMSE量表在筛查HAND患病率,两组之间无差别（x2=2.37,P=0.124）.结论 MoCA量表在筛查HIV相关性认知功能损害的敏感性优于MMSE量表,比较适合目前临床上HAND的早期筛查。

Objective To compare the performance of Montreal cognitive assessment scale （MoCA） and minimental state examination scale （MMSE） in screening HIV-associated neurocognitive disorders （HAND）.Methods A case-control study of 127 HIV ＋ and 60 HIV-individuals.All the subjects＇ cognitive functions were assessed using MoCA and MMSE separately.Results Mean MoCA score in cases was 26.28 ± 2.43 compared to 27.33 ± 1.30 in controls （P 〈 0.01）.Mean MMSE score in cases was 27.45 ± 1.31 compared to 27.70 ±0.89 in controls （P =0.139）.Using the MoCA screening revealed 43 （33.9%） cases had HAND compared with 6 （6.7 %） controls （x2 =16.01,P 〈 0.001）.Using MMSE,6 （4.7%） cases and 1（1.7%） control had HAND （P=0.124）.Conclusion The MoCA scale is more sensitive in deteting HAND than MMSE and is suited for the early cognitive screening of HIV patients in clinic.