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MMSE和MoCA量表在帕金森病伴认知功能障碍筛查中的应用及相关危险因素分析

  • 刘茹

* 通信作者: 刘茹, 单位:河北省保定市第三中心医院 071000

摘要


目的:探究蒙特利尔认知评估量表(MoCA)、简易精神状态量表(MMSE)在帕金森病(PD)认知功能障碍筛查中的应用效果,并对PD认知功能障碍的相关危险因素进行分析。

方法:选取于我院诊疗的PD患者126例作为研究对象,根据其是否合并有认知功能和认知障碍程度,将其分为合并认知障碍组(PD-CI,53例)和不合并认知功能障碍组(PD-NCI,73例),分别采用MoCA和MMSE评估患者的认知功能情况,比较MMSE评估量表和MoCA评估量表在PD认知功能障碍患者筛查中的准确性,同时分析年龄、性别、受教育程度、病程、UPDRSII评分、UPDRSIII评分、HAMA评分、HAMD评分等相关因素与PD患者发生认知功能障碍的关系。

结果:MMSE评分量表的诊断灵敏度和漏诊率明显低于MoCA评分量表,而特异度和误诊率显著高于MoCA评分量表,差异具有统计学意义(p < 0.05)。两组患者年龄、受教育年限、病程、UPDRSII、UPDRSIII、HAMA以及HAMD差异具有统计学意义(p < 0.05),为PD患者发生认知障碍的危险因素。Logistic回归分析

结果显示,受教育年限、UPDRSII、UPDRSIII、HAMA以及HAMD与PD-CI的发病关系密切,是PD-CI发病的独立危险因素(p < 0.05)。

结论:MoCA量表具有更高的敏感性和较低的漏诊率,是PD患者是否合并认知功能障碍较为理想的筛查工具,值得在临床工作中推广应用。年龄、受教育年限、病程、UPDRSII评分、UPDRSIII评分、HAMA评分以及HAMD评分是PD患者发生认知障碍的危险因素,其中受教育年限、UPDRSII、UPDRSIII、HAMA以及HAMD与PD-CI发病关系密切,是PD-CI发病的独立危险因素。

关键词:帕金森病;认知功能障碍;筛查;相关因素分析

ABSTRACT


Objective:The research of Montreal cognitive assessment scale (MoCA), Mini Mental State Examination (MMSE) in Parkinson's disease (PD) application for the screening of cognitive impairment, and related risk factors of cognitive impairment in PD analysis.

Methods:In our hospital 126 cases of patients with PD as the research object, according to the presence of cognitive function and the degree of cognitive impairment, which can be divided into combined cognitive impairment group (PD-CI, n = 53) and patients without cognitive dysfunction group (PD-NCI, n = 73), MoCA and MMSE were used to assess the cognitive function of patients the comparison of MMSE scale and MoCA scale in the accuracy of the PD cognitive dysfunction in screening patients at the same time, the relationship between factors related to age, gender, education level, disease duration, UPDRSII score, UPDRSIII score, HAMA score, HAMD score and cognitive dysfunction in PD patients analysis.

Results:The diagnostic sensitivity and missed diagnosis rate of the MMSE score scale were significantly lower than those of the MoCA scale, while the specificity and misdiagnosis rate were significantly higher than those of the MoCA scale, the difference was statistically significant (p< 0.05). The differences in age, education, disease duration, UPDRSII, UPDRSIII, HAMA and HAMD between the two groups were statistically significant (p < 0.05), which were the risk factors for cognitive impairment in PD patients. Logistic regression analysis showed that years of education, UPDRSII, UPDRSIII, HAMA and HAMD were closely related to the incidence of PD-CI, which was an independent risk factor for PD-CI (p < 0.05).

Conclusion  :The MoCA scale has higher sensitivity and lower the rate of misdiagnosis is PD patients with cognitive dysfunction screening tool is ideal, it is worthy of popularization and application in clinical work. Age, years of education, course of disease, UPDRSII score, UPDRSIII score, HAMA score and HAMD score were risk factors of cognitive impairment in patients with PD among them, UPDRSII, UPDRSIII, HAMA and HAMD and PD-CI closely, is an independent risk factor in the pathogenesis of PD-CI.

Key words: Parkinson's disease; Cognitive dysfunction; Scale assessment; Analysis of related factors

引用本文 / How to Cite This Article

刘茹.MMSE和MoCA量表在帕金森病伴认知功能障碍筛查中的应用及相关危险因素分析[J]. 国际精神病学杂志, , (): -

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