中华神经科杂志
中華神經科雜誌
중화신경과잡지
Chinese Journal of Neurology
2008年
4期
234-237
,共4页
郭起浩%付建辉%袁晶%赵倩华%曹歆轶%洪震
郭起浩%付建輝%袁晶%趙倩華%曹歆軼%洪震
곽기호%부건휘%원정%조천화%조흠질%홍진
阿尔茨海默病%认知障碍%神经心理学测验
阿爾茨海默病%認知障礙%神經心理學測驗
아이자해묵병%인지장애%신경심이학측험
Alzheimer's disease%Cognition disorders%Neuropsychological tests
目的 编制和验证画钟测验(CDT)新的评分方法.方法 对188名健康中老年人、170例轻度认知障碍(MCI)患者和81例轻度阿尔茨海默病(AD)患者进行CDT等一系列神经心理测验.CDT 30分法包括先锚定12-3-6-9 4个点,称为"30分法-A",共4分;反映画钟结果的其余13项,称为"30分法-C",共26分,总分30分.38例被试者完成氙-CT(Xe-CT)检查,定量测量脑26个区域的局部血流量(rCBF).结果 CDT 30分法的14个项目分与总分的相关系数r=0.48～0.71,均有显著的相关性(P＜0.01)."30分法-C"与空间知觉和执行功能指标的相关性较大(r=0.58～0.64),而"30分法-A"与记忆指标的相关性较大(r=0.67)."30分法-A"≤2分,识别MCI的敏感性为70.6%,特异性为73.9%,"30分法-C"≤17分,识别MCI的敏感性为38.2%,识别轻度AD的敏感性为75.3%,特异性为75.9%.CDT与Xe-CT检测的rCBF的关系:"30分法-A"和"30分法-C"的回归方程中,入选的自变量分别为左额叶下区和右白质区.结论 "30分法"A和C两部分具有不同的意义,"30分法-C"可用于识别AD,而"30分法-A"有助于MCI的识别.
目的 編製和驗證畫鐘測驗(CDT)新的評分方法.方法 對188名健康中老年人、170例輕度認知障礙(MCI)患者和81例輕度阿爾茨海默病(AD)患者進行CDT等一繫列神經心理測驗.CDT 30分法包括先錨定12-3-6-9 4箇點,稱為"30分法-A",共4分;反映畫鐘結果的其餘13項,稱為"30分法-C",共26分,總分30分.38例被試者完成氙-CT(Xe-CT)檢查,定量測量腦26箇區域的跼部血流量(rCBF).結果 CDT 30分法的14箇項目分與總分的相關繫數r=0.48～0.71,均有顯著的相關性(P＜0.01)."30分法-C"與空間知覺和執行功能指標的相關性較大(r=0.58～0.64),而"30分法-A"與記憶指標的相關性較大(r=0.67)."30分法-A"≤2分,識彆MCI的敏感性為70.6%,特異性為73.9%,"30分法-C"≤17分,識彆MCI的敏感性為38.2%,識彆輕度AD的敏感性為75.3%,特異性為75.9%.CDT與Xe-CT檢測的rCBF的關繫:"30分法-A"和"30分法-C"的迴歸方程中,入選的自變量分彆為左額葉下區和右白質區.結論 "30分法"A和C兩部分具有不同的意義,"30分法-C"可用于識彆AD,而"30分法-A"有助于MCI的識彆.
목적 편제화험증화종측험(CDT)신적평분방법.방법 대188명건강중노년인、170례경도인지장애(MCI)환자화81례경도아이자해묵병(AD)환자진행CDT등일계렬신경심리측험.CDT 30분법포괄선묘정12-3-6-9 4개점,칭위"30분법-A",공4분;반영화종결과적기여13항,칭위"30분법-C",공26분,총분30분.38례피시자완성선-CT(Xe-CT)검사,정량측량뇌26개구역적국부혈류량(rCBF).결과 CDT 30분법적14개항목분여총분적상관계수r=0.48～0.71,균유현저적상관성(P＜0.01)."30분법-C"여공간지각화집행공능지표적상관성교대(r=0.58～0.64),이"30분법-A"여기억지표적상관성교대(r=0.67)."30분법-A"≤2분,식별MCI적민감성위70.6%,특이성위73.9%,"30분법-C"≤17분,식별MCI적민감성위38.2%,식별경도AD적민감성위75.3%,특이성위75.9%.CDT여Xe-CT검측적rCBF적관계:"30분법-A"화"30분법-C"적회귀방정중,입선적자변량분별위좌액협하구화우백질구.결론 "30분법"A화C량부분구유불동적의의,"30분법-C"가용우식별AD,이"30분법-A"유조우MCI적식별.
Objective To set up and verify a new scoring system of clock drawing test(CDT).Methods CDT and other neuropsychological tests were applied to 180 normal individuals.170 subjects with mild cognitive impairment(MCI),and 31 patients with mild Alzheimer's disease(AD).The first step of the 30-score system of CDT was to anchor the 4 points of"12-3-6-9".totaling a score of 4 which was the "30-score system A(Anchoring)part";and the other 13 items reflecting the drawing results and totaling a score of 26 made up the so called"30-score system C(Clockfaee)part".the two together had a total score of 30.Thirty-eight subjects underwent Xe-enhanced computed tomography(Xe-CT)scanning for quantitively measuring regional cerebral blood flow(rCBF)of 26 regions of brain.Results Correlations coefficients of the scores of 14 items with the total score in 30-score system of CDT were in the range of 0.48to 0.71(P＜0.01).30-score system C part was closely correlated with indicators of visuospatial and executive function,while 30-score system A part with memory indicators.The sensitivity and specificity of the 30-score system A part score≤2 for detecting MCl were 70.6%and 73.9%.respectively.The sensitivity the specificity of 30-score system C part score≤17 for mild AD were 75.3%and 75.9%.respectively.In the regression equation of 30-score system A and C part.the combined independent variables were the CBF of left frontal cortex and right white matter,respectively.Conclusion The 30-score system A and C part have difierent meanings:30-score system C part could be used to identify AD while 30-score system A part is helpful for identiring MCI.
