颈动脉彩超联合MoCA认知评估量表在老年痴呆患者临床检测中的应用价值

目的探讨经颈动脉彩超联合MoCA认知评估量表在老年痴呆患者临床检测中的应用价值。方法以2017年10／1至12月行老年痴呆检查患者86例，将符合美国国立神经病学老年痴呆症诊断标准46例为老年痴呆组，而不符合老年痴呆症诊断标准42例为非老年痴呆组，两组患者均行经颈动脉彩超联合MoCA认知评估量表检查，比较两组患者的颈动脉彩超检查指标（颈总动脉和颈内动脉的血峰值流速、颈动脉内径及动脉血流阻力指数）和MoCA认知评估量表评分差异，并绘制颈动脉彩超联合MocA认知评估量表预测结果的ROC曲线图。结果老年痴呆组患者颈总动、颈内动颈的动脉血峰值流速、内径及M0cA认知评估量表评分显著低于非老年痴呆组（P〈0．01），而颈总动、颈内动颈的动脉血流阻力指数显著高于非老年痴呆组（P〈0．叭）；检测敏感性为91．51％，检测特异性为9003％。结论颈总动脉和颈内动脉血峰值流速较低、内径较小、血流阻力指教较大和MoCA认知评估量表评分较低是老年痴呆患者临床检查中较为明显的临床特征，联合检测对老年痴呆患者临床预测具有较高的敏感性和特异性。

Objective To explore the application value of carotid artery color Doppler ultrasound combined with MoCA cognitive assessment scale in the clinical examination of senile dementia patients. Methods 86 cases of Alzheimer＇s disease were selected from October 2017 to December, and 46 cases of Alzheimer＇s disease were set in the group of Alzheimer＇s disease, and 42 cases of non-Alzheimer＇s disease were set as non-senile dementia group. Two groups of patients were examined by carotid ultrasound combined with MoCA cognitive assessment scale. The two groups of patients with carotid artery ultrasonography index （ common carotid artery and internal carotid artery blood flow velocity, carotid artery diameter and peak blood flow resistance index ） and MoCA cognitive assessment scale score difference were compared and the carotid artery color Doppler ultrasound combined with MoCA cognitive assessment ROC curve prediction was drawn. ResuLts The senile dementia in patients with carotid artery and internal carotid artery were arterial blood peak velocity, diameter and MoCA cognitive assessment of carotid was significantly lower than that in non-dementia group （ P〈0.01 ） , and the common carotid artery and internal carotid artery carotid artery resistance index was significantly higher than that in non-dementia group （ P〈0.01 ） ; IKOC curve located in the reference line, the detection sensitivity was 91.51%, specificity was 90.03%. Conclusion The low peak flow velocity of the common carotid artery and the internal carotid artery, the small internal diameter, the large blood flow resistance index and the low score of the MoCA cognitive assessment scale arc the more obvious clinical features in the clinical examination of Alzheimer＇s disease. Combined detection has high sensitivity and specificity in clinical prediction of Alzheimer＇s disease.