蒙特利尔认知评估量表在帕金森病伴轻度认知功能障碍患者中的应用研究

关键词：蒙特利尔认知评估量表  简易精神状态检查量表  帕金森病  轻度认知功能障碍

Keywords:Montreal cognitive assessment  mini-mental state examination  Parkinson's disease  mild cognitive impairment

摘要：

      摘要 目的：评估蒙特利尔认知评估量表（MoCA）在帕金森病伴轻度认知功能障碍患者中的应用价值。 方法：首先收集帕金森病患者140例，经临床评估筛查出帕金森病伴轻度认知功能障碍组（PD-MCI组）71例和帕金森病不伴认知功能障碍组（PD-NC组）69例。对两组患者分别进行MoCA和简易精神状态检查量表（MMSE）检测，最后根据两个量表的得分情况进行比较分析。 结果：PD-MCI组的MoCA和MMSE得分分别为（21.00±4.113）分和（27.62±2.344）分，结果明显低于对照组的（27.72±2.595）分和（28.75±1.566）分，具有显著差异（P＜0.01）。以26分为界，MoCA筛选敏感性为90.14%，特异性为79.71%，而MMSE敏感性仅为28.17%，特异性为96.65%。PD-MCI组患者在视空间与执行、注意、语言、抽象、延迟回忆、定向力等认知领域得分明显低于对照组（P＜0.01）。 结论：MoCA量表是PD-MCI患者比较理想的筛查工具，与MMSE相比具有更高的敏感性。MoCA量表在临床上的推广，有助于临床医师快速客观地评价PD患者早期的认知情况。

Abstract:

      Abstract Objective: To determine the diagnostic value of Montreal cognitive assessment(MoCA) to evaluate mild cognitive impairment (MCI) for Parkinson's disease(PD) patients. Method: A total of 140 participants were recruited: 71 patients were diagnosed as PD with MCI(PD-MCI group) and 69 patients as PD with normal cognitive function(PD-NC group). Both groups were assessed with MoCA and mini-mental state examination(MMSE). The discriminate validities of MoCA and MMSE as screening and diagnostic instruments were ascertained. Result: MoCA and MMSE scores were (21.00±4.113) and (27.62±2.344) in PD-MCI group respectively. These scores were significantly lower than that in PD-NC group(27.72±2.595, P＜0.01) and (28.75±1.566, P＜0.01) for MoCA and MMSE respectively. With a cut-off score of 26 points, MoCA showed sensitivity of 90.14% and specificity of 79.71% in the detection of MCI in PD patients, while MMSE showed 28.17% and 96.65% separately. PD-MCI group exhibited significant worse performance in digit,space, attention, verbal memory, abstraction and language abilities(P＜0.01). Conclusion: The MoCA has adequate psychometric properties as a screening instrument for the detection of MCI in PD patients. It has higher sensitivity when compared with MMSE.