4种神经心理学量表在阿尔茨海默病早期诊断中的应用比较研究

Comparative of four neuropsychological scales in early diagnosis of Alzheimer’s disease

摘要:

目的：评估4种神经心理学量表在阿尔茨海默病（Alzheimer’s disease，AD）早期诊断中的应用价值。方法：对109例受试者：AD组24例、轻度认知功能损害（mild cognitive impairment，MCI）组40例、正常认知（normal cognition，NC）组45例，采用记忆及执行功能筛查量表（memory and executive screening，MES）、听觉词语学习测试华山版（auditory verbal learning test-Huashan version，AVLT-H）、简易智能状态量表（mini-mental state examination，MMSE）、蒙特利尔认知评估量表（Montreal cognitive assess－ment scale，MoCA）4种量表测试，对测试结果进行比较分析。结果：每种量表评分在3组间均具有统计学差异（P＜0.01）；AVLT-H短延迟回忆及长延迟回忆与文化程度无显著相关性（P ＞0.05）；以MES评分80分为临界值诊断MCI的敏感度及特异性分别为95.6%和75.0%，AVLT-H长延迟回忆取4分为临界值诊断MCI的敏感度及特异性最高（100.0%和99.84%）。结论：MES及AVLT-H对AD早期具有很高的诊断价值且不受文化程度影响。

Abstract:

Objective：To evaluate the diagnostic value of four neuropsychological scales in early diagnosis of Alzheimer’s disease（AD）. Methods：Totally 109 subjects were divided into three groups：24 in AD group，40 in mild cognitive impairment（MCI） group，45 in normal cognition（NC） group. Four scales were adopted including memory and executive screening（MES），auditory verbal learning test-Huashan version（AVLT-H），mini-mental state examination（MMSE）and Montreal cognitive assessment scale（MoCA）. Scores of the four scales were compared and analyzed. Results：For each scale，there were significant differences among the scores of three groups（P＜0.01）. The scores of short-term and of AVLT-H were not correlated with education level（P ＞0.05）. The sensitivity and specificity of MES were 95.6% and 75.0% respectively using a cut-off score of 80. The sensitivity and specificity reached the highest （100.00% and 99.84%） when taking a cut-off score of 4 in long-term delay recall of AVLT-H. Conclusions：Both MES and AVLT-H are of great value in diagnosing AD at early stage and are not influenced by the education level.