画钟实验和图片记忆测试在识别老年认知功能障碍中的临床应用

The clinical application of the scenery picture memory test combined with clock drawing test and clock reading test to screen the cognitive impairment patients in the elderly

目的比较风景图片记忆测试(SPMT)与画钟实验(CDT)、读钟实验(CRT)对筛查轻度认知障碍(MCI)、早期及中晚期阿尔茨海默病(AD)患者的临床意义。方法 182受试者中,经简易智力状态检查量表(MMSE)筛查,45例(24.73%)为MCI患者,38例(20.89%)为早期AD患者,25例(13.74%)为中重度AD患者,74例(29.38%)为健康者。受试者被分为正常健康组、轻度认知功能障碍组、早期AD组及中晚期AD组,共计4组。所有受试者均给予MMSE、CDT、CRT及SPMT测试。结果 SPMT在区分MCI患者的敏感性及特异性分别为76.25%、79.83%,CDT分别为41.06%、77.65%,CRT分别为36.03、57.80%,三者之间差异有统计学意义(P<0.05)。SPMT在区分早期AD患者的敏感性及特异性为82.33%、86.44%,CDT分别为72.0%、79.83%,CRT分别为49.23%、85.62%,三者间差异无统计学意义(P>0.05)。SPMT在区分中晚期AD患者的敏感性及特异性为77.85%、84.29%,CDT分别为77.14%、77.85%,CRT分别为54.30%、59.90%,三者之间差异无统计学意义(P>0.05)。结论 SPMT可以作为一个诊断轻度认知功能障碍的有效工具,值得临床推广。

Objective To investigate the sensitivity and specificity of Scenery Picture Memory Test and combined with the the Clock Drawing Test（CDT） and clock reading（CRT） to screen the mild cognitive impairment and AD patients in the elderly. Methods All of the subjects were recruited from the outpatient department of the Third Hospital of Hangzhou and the memory disorder clinic. All the subjects were given MMSE, SPMT, CDT and CRT. According to the test Results The 182 subjects were divided into normal group, mild cognitive impairment group, early AD group and progressed AD group. In the 4 groups, with 45 （ 24.73% ） of the dementia diagnosed with MCI, 38 （ 13.74% ） were early AD, 25 （ 13.74% ） were diagnosed with moderate to severe AD ,74 （ 29.38% ） were normal health . Results ： The sensitivity and specificity of SPMT in patients with MCI were 76.25% ＆ 79.83% ,compared with CDT（41.06% ,77.65% ） and CRT （36.03% ,57.80% ） , it is significantly higher than the latter. However, there was no significant difference in the sensitivity and specificity among SPMT （ 82.33 % , 86.44 % ）, CDT （ 72.0% ,79.83 % ） and CRT （ 49.23 % , 85.62% ） in diagnosis of early AD（P 〉0.05）. The similar results were observed in the progressed AD group,the sensitivity and specificity of SPMT was 77.85% and 84.29% ,CDT was 77.14% ,77.85% ,and CRT was 54.30% ,59.90% ,respectively. Conclusion SPMT can be used as an effective approach to screen the mild and early cognitive impairment in the elderly.