汉化版Addenbrooke认知功能检查量表第3版在小脑梗死患者认知功能评价中的应用

The application of the Chinese version of Addenbrooke's cognitive examination versionⅢon cognitive as⁃sessment in patients with cerebellar infarction

目的:评价汉化版Addenbrooke认知功能检查量表第3版(Addenbrooke's cognitive examination versionⅢ,ACE-Ⅲ)应用于小脑梗死患者认知功能评估的可行性。方法:收集于北京天坛医院神经内科住院并通过影像学检查确诊为局灶性小脑梗死的患者40例,并招募与病例组年龄及教育程度匹配的健受试者40例。收集人口学指标并评价运动功能缺损程度。采用ACE-Ⅲ进行认知功能评价。通过Cronbachα系数评价ACE-Ⅲ信度;通过受试者工作特征曲线评价其校标关联效度。应用Spearman相关性分析评价ACE-Ⅲ得分与年龄、受教育水平之间的相关性。结果:病例组和健康对照的ACE-Ⅲ总分分别为(88.3±6.0)分及(93.1±3.0)分,存在显著差异(P<0.001)。病例组的注意力(P<0.001)、语言流畅性(P<0.001)及视空间(P=0.001)功能显著下降。ACE-Ⅲ总体Cronbachα系数为0.58。ACE-Ⅲ总分的曲线下面积为0.79±0.05(95%置信区间:0.69—0.89)。依据约登指数,88分是ACE-Ⅲ量表的最佳截止值。此外,ACE-Ⅲ得分与年龄在病例组(r=﹣0.52,P<0.0001)及对照组(r=﹣0.67,P<0.001)中呈显著负相关,与受教育年限在病例组(r=0.74,P<0.01)及对照组(r=0.72,P<0.0001)中呈显著正相关。结论:ACE-Ⅲ量表可较好地应用于小脑梗死患者认知功能障碍的筛查,其得分与年龄、受教育程度相关。

Objective:To evaluate the feasibility of using the Chinese version of Addenbrooke's cognitive examination versionⅢ(ACE-Ⅲ)on cognitive assessment in patients with cerebellar infarction.Method:Forty patients with isolated cerebellar infarction were collected in the department of neurology,Beijing Tiantan Hospital,along with 40 healthy controls were recruited matched by age and education.The clinical demographics was collected and the severity of ataxia and balance dysfunction was assessed.ACE-Ⅲwas used to evaluate cognitive function.The Cronbach's alpha and receiver operating characteristic(ROC)curve were used to assess the reliability and validity of ACE-Ⅲrespectively.Furthermore,the correlation of ACE-Ⅲtotal score with age and education was examined by spearman analysis.Result:The total score of ACE-Ⅲin patients'group and healthy controls was 88.3±6.0 and 93.1±3.0 respectively,showing a significant different(P<0.001).Compared with healthy group,patients with cerebellar infarction had lower performance in attention(P<0.001),language fluency(P<0.001)and visuo-spatial function(P=0.001).The overall Cronbach's alpha of ACE-Ⅲwas 0.58,and the area under curve was 0.79±0.05(95%confidence interval:0.69—0.89).According to Youden index,the optimal cut-off for ACE-Ⅲwas 88.Furthermore,spearman analysis showed cognitive function was significant negative associated with age in patients'group(r=﹣0.52,P<0.0001)and healthy controls(r=﹣0.67,P<0.001),and was significant positive associated with education in patients'group(r=0.74,P<0.01)and healthy controls(r=0.72,P<0.0001)Conclusion:ACE-Ⅲscale is a good tool to detect cognitive dysfunction in patients with isolated cerebellar infarction.The total score of ACE-Ⅲis associated with age and educational attainment.