兰州大学机构库 >学院待认领
静止性脑梗死患者认知障碍的研究
Alternative TitleResearch of cognitive impairment in patients with silent cerebral infarction
乾栋梁
Thesis Advisor瞿学栋
2013-05-21
Degree Grantor兰州大学
Place of Conferral兰州
Degree Name硕士
Keyword静止性脑梗死 认知障碍 蒙特利尔量表
Abstract目的 探讨静止性脑梗死与认知障碍的关系;比较简易精神状态量表(MMSE)及蒙特利尔认知评估量表(MoCA)在静止性脑梗死合并认知障碍的应用;探讨蒙特利尔量表在静止性脑梗死患者合并轻度认知障碍中的最佳截断点;筛选静止性脑梗死合并认知障碍的危险因素。 方法 临床收集2012年2月至2012年12月兰州大学第二医院神经内科住院部及门诊部108例患者,其中静止性脑梗死患者61例作为病例组,健康老人47例作为对照组,采集入组患者的性别、年龄、心电图、脑梗死家族史、高血压病史、糖尿病史及颈动脉血管彩超检查结果等信息;使用MMSE和MoCA量表分别对病例组和对照组进行评分。 结果 1、MMSE和MoCA量表均可用于静止性脑梗死患者的认知功能评估(Z值分为别-2.301、-4.067;P值分别为0.021、0.000);2、MoCA量表对静止性脑梗死合并认知障碍的评估效用优于MMSE(曲线下面积0.726>0.627);3、MoCA评分截断点为25时,灵敏度和特异度均高,分别为0.705和0.638;4、利用多自变量logistic回归分析对静止性脑梗死合并认知障碍的可能危险因素进行筛选,颈动脉2个及以上斑块(P=0.027),年龄在60至70岁(P=0.032),年龄在70岁以上(P=0.005)是其危险因素。 结论 静止性脑梗死患者可能会合并认知障碍;MoCA量表比MMSE量表更适合用于静止性脑梗死的认知功能评价,更利于发现轻度认知障碍,可广泛应用于静止性脑梗死患者的认知评估尤其在以25分为截断值时,灵敏度和特异度均高,可作为判定是否合并有认知障碍的截断分值。静止性脑梗死患者颈动脉存在2个及以上斑块者;年龄在60岁以上者可能容易患认知障碍。
Other AbstractObjective To investigate the relationship between Silent Cerebral Infraction (SCI) and cognitive impairment and analyse the screening effect of the Mini-mental State Examination and Montreal Cognitive Assessment (MoCA) for SCI, determine optimal cut-off-point of the MoCA in SCI patients with mild cognitive impairment(MCI) , and screen the risk factors of SCI with cognitive impairment. Methods From February 2012 to December 2012, we recruit 108 individuals into 2 groups: 61 individuals in SCI group and 47 individuals in control group. Collected the information including gender, age, Electrocardiogram (ECG), carotid artery ultrasound, family history of cerebral infarction, history of hypertension, history of diabetes, MMSE scores, MoCA scores. Results 1. Both MMSE and MoCA scores had significant difference between the two groups (Z=-2.301, Z=-4.067,P<0.05). 2.MoCA was more valuable in predicting cognitive impairment than MMSE (area under the curve 0.726>0.627). 3.The MoCA has a good balance of sensitivity and specificity at cut-score of 25. 4.Two and more carotid artery plaques(P=0.027), age between 60 and 70(P=0032), age (>70)(P=0.005) were screened out as the risk factors of SCI with cognitive impairment. Conclusions The patient with SCI might accompany with cognitive impairment, MoCA might be more valuable in predicting vascular cognitive impairment than MMSE and should be widely used in SCI patients, it has a good balance of sensitivity and specificity at the cut-score of 25. The SCI patient with two and more carotid artery plaque or age≥60 might more likely to accompany with cognitive impairment.
URL查看原文
Language中文
Document Type学位论文
Identifierhttps://ir.lzu.edu.cn/handle/262010/223177
Collection学院待认领
Affiliation临床医学院
Recommended Citation
GB/T 7714
乾栋梁. 静止性脑梗死患者认知障碍的研究[D]. 兰州. 兰州大学,2013.
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