基于黔北2型糖尿病患者探讨MMSE和MoCA量表对认知障碍患者的筛查作用

Discussion on MMSE and MoCA in Screening effect on patients with cognitive impairment based on T2DM patients in northern Guizhou

目的:基于黔北地区中老年2型糖尿病(Type 2 Diabetes Mellitus,T2DM)患者探讨MMSE和MoCA量表在认知障碍患者的筛查作用。方法:选择2018年2月-2019年2月在遵义医科大学第三附属医院住院的中老年T2DM患者31例,分别采用简易智力状态检查量表(MMSE)和蒙特利尔认知评估量表(Montreal Cognitive Assessment,MoCA)对其认知功能进行评估和两量表得分进行比较,并采用一致性检验分析两者一致性。结果:认知功能障碍组与正常组MMSE与MoCA量表评分比较,正常组MMSE得分[28.00(27.25,29.00)]高于认知功能障碍组[24.00(21.00,26.00)],差异有统计学意义;正常组MoCA得分[27.00(26.50,29.00)]高于认知功能障碍组[19.00(16.00,22.25)],差异有统计学意义;MMSE与MoCA量表一致性检验的Kappa=0.314,一般一致性,MoCA诊断的阳性率(83.87%)高于MMSE(61.29%);MoCA+MMSE与MoCA量表一致性检验的Kappa=0.421,中等一致性;MoCA+MMSE与MMSE量表一致性检验的Kappa=0.933,高度一致性。结论:联合应用MMSE与MoCA量表进行认知功能障碍患者进行筛查,有望提高在临床工作中对认知障碍患者的诊断效力,更适合基层开展。

Objective To explore the screening effect of MMSE and MoCA scales in patients with cognitive impairment based on middle-aged and elderly T2DM patients in northern Guizhou.Methods From February 2018 to February 2019,31 middle-aged and elderly T2DM patients who were hospitalized in the Third Affiliated Hospital of Zunyi Medical University were selected.The simple mental status examination scale(MMSE)and the Montreal cognitive assessment scale(montreal cognitive assessment scale),(MoCA)to evaluate its cognitive function and compare the scores of the two scales,and use consistency test to analyze the consistency of the two.Results Compared with the scores of MMSE and MoCA in the cognitive dysfunction group and normal group,the MMSE score of the normal group was higher than that of the cognitive dysfunction group[28.00(27.25,29.00)vs 24.00(21.00,26.00),Z=-4.66,P<0.001];the MoCA score of the normal group is higher than that of the cognitive dysfunction group[27.00(26.50,29.00)vs 19.00(16.00,22.25),Z=-3.51,P<0.001];MMSE and MoCA scale consistency test Kappa=0.314,general consistency,MoCA diagnosis positive rate(83.87%)is higher than MMSE(61.29%);MoCA+MMSE and MoCA scale consistency test Kappa=0.421,moderate Consistency;Kappa=0.933 in the consistency test between MoCA+MMSE and MMSE scale,which is highly consistent.Conclusion The combined application of MMSE and MoCA scales for the screening of patients with cognitive dysfunction is expected to improve the diagnostic efficacy in clinical work for patients with cognitive impairment,and the combination of the two scales is relatively simple and more suitable for grassroots development.