听觉词汇学习测验对于轻度认知障碍转归的预测价值研究

Prediction value of auditory vocabulary learning test for outcomes of mild cognitive impairment

目的研究听觉词汇学习测验(auditory vocabulary learning test,AVLT)对轻度认知障碍(mild cognitive impairment,MCI)进展为痴呆的预测能力。方法对257例MCI患者进行纵向随访,然后根据临床结果将其分为痴呆进展组和非痴呆进展组。比较这些组的基线人口统计学信息和AVLT评分。构建受试者工作特征(receiver operating characteristic,ROC)曲线以评估AVLT评分对MCI转归的区分值。结果在6年后的随访中,有45例受试者进展为痴呆,归为痴呆进展组(MCI progression,MCIp),3例受试者恢复正常认知,209例受试者维持MCI,一同归为非痴呆进展组(MCI non-progression,MCInp)。在基线时,MCIp组的AVLT评分明显低于MCInp,差异有统计学意义(P<0.05)。ROC曲线分析显示,AVLT延迟回忆(delayed recall,AVLT-DR)在区分MCI患者进展为痴呆方面有最大的曲线下面积(largest area under the curve,AUC),是重要预测指标。结论AVLT,尤其是AVLT-DR评分较低能较好预测MCI进展为痴呆,但由于其特异度偏低,需要联合其他特异度高的量表综合使用来运用于临床工作。

Objective To investigate the predictive ability of auditory vocabulary learning test(AVLT)for the progression of mild cognitive impairment(MCI).Methods A total of 257 MCI patients were followed up for 5 years,among whom 45 cases progressed to dementia(MCIp group)and 212 cases did not progressed,including 3 cases regained normal cognition(MCInp group).Baseline demographics information and AVLT scores were compared between two groups.The value of AVLT score in prediction of progression of MCI patients was analyzed by receiver operating characteristic(ROC)curve.Results At baseline,the AVLT scores in the MCIp group was significantly lower than those in the MCInp group(P<0.05).ROC curve analysis showed that AVLT delayed recall(AVLT-DR)had the largest area under the curve(AUC)in distinguishing MCIp patients from MCInp,and was an important predictive indicator.Conclusion Lower AVLT score,especially lower AVLT-DR score,is an indicator for the progression in MCI patients,which is worthy of clinical application.