【摘要】 目的研究比较简易精神状态量表(MMSE)与中文版蒙特利尔认知评价量表(MoCA)在脑肿瘤患者认知障碍中的诊断筛查作用。方法对年龄、性别及教育水平构成无统计学差异的两组受试者在同一天内进行MoCA和MMSE评测,并逐一比较两组受试者各亚项得分以确定脑肿瘤患者的认知功能,比较两个量表对筛查脑肿瘤患者认知功能的差异。结果 308例脑肿瘤患者中,综合评估有认知障碍的139例,发生率45.1%;MoCA和MMSE对脑肿瘤患者认知功能障碍都具有初步的筛查作用。MoCA的敏感性为82.0%,特异性为92.7%。MMSE的敏感性为19.4%,特异性为100%。结论 MoCA敏感性高于MMSE,而特异性与MMSE相近,亚项设置较为复杂合理,能全面评价脑肿瘤患者的认知功能,更适合于具有广泛认知功能障碍的脑肿瘤患者。更多还原

【Abstract】 Objective To compare the value of mini-mental state examination (MMSE) to assessment of cognitive function in patients with brain tumors with that of Montreal cognitive assessment scale (MoCA). Methods Three hundred and two patients with brain tumors (tumor group) and two hundred normal relatives of the patients with brain tumors (control group) were recruited in this study. The examinations of MMSE and MoCA were performed in the tumor group and control group. Then the scores of MMSE and MoCA were analyzed statistically. Results Both overall scores of MMSE and MoCA were significantly lower in tumor group than those in control group (P <0.01). According to comprehensive evaluation including chief complains, MMSE, MoCA, comparison to control group and physician assessment, the incidence of cognitive impairment was 45.1% (139/308) in tumor group. According to MoCA, 129 patients in tumor group had cognitive impairment, of whom 114 had cognitive impairment according to comprehensive evaluation and 15 not. The sensitivity and specificity of MoCA were 82.0% and 92.7% respectively. According to MMSE, 27 of 139 patients who had cognitive impairment in tumor group according to comprehensive evaluation, had cognitive impairment. The sensitivity and specificity of MMSE were 19.4% and 100% respectively. Conclusions The MoCA is more sensitive than the MMSE to screening cognitive impairment in patients with brain tumors although they have similar specificity. The setting of MoCA sub-items is more reasonable and suitable to evaluating cognitive function in patients with brain tumors.更多还原