简易精神状态检查评分正常的脑外伤患者行为记忆测评分析

Behavioral Memory Assessment for Traumatic Brain Injury Patients with Normal Result in Mini-Mental State Examination

目的观察简易精神状态检查(MMSE)测评得分正常的脑外伤患者在蒙特利尔认知评估量表(MoCA)和Rivermead行为记忆测评(RBMT-3)中的表现。方法 2015年3月至2018年6月,选择有明确主诉,但MMSE筛查为认知功能正常的脑外伤患者40例(患者组),以及同期健康体检者30例(对照组),先后采用MMSE、MoCA和RBMT-3进行测试。结果患者组中14例MoCA评分正常。患者组MoCA总分、RBMT-3总粗分和总量表分均明显低于对照组(t>2.822, P <0.01);MoCA言语和延迟回忆分均明显低于对照组(t> 2.790, P <0.01),RBMT-3各项中故事延迟回忆、技能学习即时回忆和技能学习延迟回忆粗分和分量表分均低于对照组(t> 2.507, P <0.05),RBMT-3记住姓名延迟回忆和故事即时回忆粗分低于对照组(t> 2.018, P <0.05)。结论对存在明确主诉的脑外伤患者,建议联合使用MMSE和MoCA进行筛查,记忆损害症状明显的可进一步采用RBMT-3进行评定。

Objective To observe the performance of the traumatic brain injury (TBI) patients with normal results in Mini-Mental State Examination (MMSE) in the Montreal Cognitive Assessment (MoCA) and Rivermead Behavioral Memory Test-3 (RBMT-3). Methods From March, 2015 to June, 2018, 40 TBI patients with cognitive complaints but normally in MMSE and other 30 healthy persons (controls) were assessed with MoCA and RBMT-3. Results There were 14 patients sounded normally in MoCA. The scores of MoCA, as well as both the raw score and scale score of RBMT-3, were less in the patients than in the controls (t > 2.822, P < 0.01), especially in the verbal and delayed recall subtests of MoCA (t > 2.790, P < 0.01), and delayed story recall, skill learning instant recall, delayed skills recall (both raw and scale scores)(t > 2.507, P < 0.05), and remember name delay recall and story instant recall (raw score only)(t > 2.018, P < 0.05) of RBMT-3. Conclusion For TBI patients with cognitive complaints, it is necessary to assesse with both MMSE and MoCA. If there is any memory impairment, RBMT-3 is needed.