目的建立系统性红斑狼疮(SLE)患者认知功能检查的床边筛查量表。方法应用改良的简易精神状态检查量表(modified mini mental status examination,MMMSE,华山医院神经内科修订版)对SLE患者进行认知功能检查,并与传统的简易精神状态检查量表(mini mental status examinmion,MMSE)检查作比较。结果①MMSE检查结果显示,神经精神性狼疮(NPSLE)组得分低于正常对照组(P＜0．01),但与SLE对照组比较差异无统计学意义(P＞0．05)；完成时间长于SLE对照组和正常对照组(P＜0．01)；SLE对照组较正常对照组在得分和完成时间上差异无统计学意义(P＞0．05)：②MMMSE检查结果显示：NPSLE组得分低于SLE对照组和正常对照组(P＜0．01),完成时间长于SLE对照组和正常对照组(P＜0．01)；而SLE对照组得分较正常对照组低,完成时间长于正常对照组,差异有统计学意义(P＜0．01)。结论MMSE一直是国内外最普及、最常用的痴呆筛查量表,但其反映认知功能损伤不够敏感,而3MSE在增加的几个项目测试中能较敏感地发现认知损伤,而且易操作、费时少(10min以内),可以用于SLE床边认知筛查。
Objective To assess whether quick cognitive screening test （QCST） could quickly identify mild cognitive impairment （MCI）. Methods QCST and a full set of standardized neuropsychological tests, including mini-mental state examination （MMSE） and montreal cognitive assessment （MoCA） were performed. A total number of 121 cases of MCI [41 cases of amnestic MCI-single domain （aMCI-s）; 44 of amnestic MCI-multiple domain （aMCI-m）; 36 of nonamnestic MCI （naMCI）], 79 cases of mild Alzheimer’s disease （AD） and 186 healthy elderly volunteers were employed in the present study. All the participants （55-85 years old） had an educational level no less than 5 years. QCST subtests included word list recall, naming test, animal fluency test, similarity test, color trail-1min, clock drawing test, finger construction test, and digit span test. The total score of QCST was 90 points, 10 points for each index of subtests. Results The total scores of QCST in MCI, AD and the control groups were （58.13±8.18）, （44.53±10.54） and （72.92±6.85） points, respectively. According to the educational level, the cut off scores of participants with an educational level of 5-8 years, 9-12 years and more than 13 years were 63, 65 and 68 points, respectively. The sensitivity and specificity of QCST in detection of MCI were 87.6% （85.7% for aMCI-s, 90.1% for aMCI-m and 89.5% for naMCI） and 84.3%, respectively. The area under the curve was 0.923 （95% CI： 0.892-0.953）. Delayed memory, color trail-1min and similarity test could help distinguish between aMCI and naMCI. Conclusion QCST may have a good sensitivity and specificity for MCI detection, which warrants its further clinical application.
