两种五分钟蒙特利尔认知评估方案评估脑卒中患者的对比研究

Application of two five-minute Montreal cognitive assessment protocols in patients with stroke

摘要:

目的：比较2种五分钟蒙特利尔认知评估方案在脑卒中患者应用中的准确性。方法：前瞻性纳入重庆医科大学附属第二医院康复医学科脑卒中患者与健康受试者，对受试者进行神经系统疾病和脑卒中-加拿大脑卒中联网提出的五分钟认知筛查方案（national institute for neurological disorders and stroke-Canadian stroke network，NINDS-CSN）、五分钟蒙特利尔认知评估方案（香港版）、蒙特利尔认知评估、神经行为认知状态检查（neurobehavioural cognitive status examination，NCSE）评估。结果：本研究纳入29名脑卒中患者与20名健康受试者。研究结果显示2种五分钟蒙特利尔认知评估方案与蒙特利尔认知评估（Mon－treal cognitive assessment，MoCA）的结果具有一致性，相关系数分别为0.918 6（P<0.000 1）、0.918 1（P<0.000 1）。NINDS-CNS五分钟评估的受试者工作特征曲线曲线下面积（area under curve，AUC）优于五分钟MoCA（香港版）（AUC=0.934；95%CI=0.825~0.985）。结论：2种五分钟蒙特利尔认知评估方案与MoCA评估效度一致，NINDS-CNS五分钟评估较五分钟MoCA更加适用于临床社区推广应用。

Abstract:

Objective：To compare the accuracy of two Montreal cognitive assessment five-minute protocols in stroke patients. Methods：A prospective observational study enrolled stroke patients and healthy subjects from the Department of Rehabilitation Medicine of The Second Affiliated Hospital of Chongqing Medical University. National institute for neurological disorders and stroke-Canadian stroke network（NINDS-CSN），Montreal cognitive assessment 5-minute protocol（Hong Kong version），Montreal cognitive assessment（MoCA）and neurobehavioral cognitive status examination（NCSE） were administered to each participant. Results：A total of 29 patients with stroke and 20 healthy controls were enrolled in this study. The results of the two Montreal cognitive assessment five-minute protocols were consistent with the results of the MoCA with correlation coefficients of 0.918 6（P<0.001） and 0.918 1（P<0.001），respectively. NINDS-CSN is better than the Montreal cognitive assessment 5-minute protocol（AUC=0.934；95%CI=0.825-0.985）. Conclusion：The validity of the two Montreal cognitive assessment five-minute protocols is consistent with that of MoCA. The NINDS-CNS five-minute assessment is more suitable for clinical community promotion and application than the MoCA 5-minute protocol.