稳定期慢性阻塞性肺疾病患者认知功能的 MoCA 量表评

目的：分析稳定期慢性阻塞性肺疾病（COPD）患者认知功能的改变，探究蒙特利尔（MoCA）量表与简明智能精神状态检查量表（MMSE）在认知功能方面评估的差异性。方法：选取在我院就诊的87例稳定期老年 COPD患者，依据有无认知障碍，分为观察组38例均有认知障碍，对照组49例均无认知障碍，分别采用 MoCA 量表与MMSE 量表对2组进行认知功能改变评估，对2组测量结果进行灵敏度、特异度以及一致性进行分析比较。结果：观察组 MoCA 量表得分总分（18.8±7.8）与 MMSE 量表得分总分（23.2±8.6）比较差异有统计学意义，对照组 MoCA 量表得分总分（24.6±6.8）分与 MMSE 量表得分总分（27.3±4.8）比较差异有统计学意义；MoCA 量表诊断 MCI 灵敏度（38/38）为100％，特异度（38/40）为95％，诊断 Kappa 值为0.954；单独使用 MMSE 量表对总样本诊断 MCI 灵敏度（29/38）为76.32％，特异度（29/40）为72.50％，诊断 Kappa 值为0.536，MoCA 量表与临床诊断 MCI 一致性更好。结论：MoCA、MMSE 量表联合应用有利于早期发现 COPD 患者认知功能障碍，且 MoCA 较 MMSE 量表更灵敏。

Assessment of cognitive function in patients with stable chronic obstructive pulmonary disease by MoCA

Objective to analyze the changes of cognitive function in patients with stable chronic obstructive pulmonary disease (COPD), and explore the differences of cognitive function between Montreal (MoCA) scale and the concise mental state exa mination scale (MMSE). Methods in our hospital in 87 patients with stable COPD in elderly patients with, according to the cognitive disorder, divided into observation group (38 cases) had cognitive impairment, 49 cases in the control group had no cognitive impairment, respectively, using MOCA and MMSE scale of two groups of cognitive function changes the evaluation, 2 sets of measurements of the sensitivity, specificity and consistency were compared and analyzed. Results in the observation group of MOCA Scale total score (18.8+7.8) and MMSE Scale total score (23.2+8.6) the difference was statistically significant , and the control group of MOCA Scale total score (24.6+6.8) and MMSE Scale total score (27.3+4.8) the difference was statisti-cally significant; MOCA scale diagnosis of MCI sensitivity (38 cases) was 100%, specificity (38 / 40) was 95%, the diagnosis of kappa 0.954 alone using the MMSE scale to the total sample diagnosis of MCI sensitivity (29 / 38) is 76.32%, specificity (29 /40) was 72.50%. Diagnosis of kappa = 0.536, MOCA scale and clinical diagnosis of MCI consistency better.Conclusion MoCA, MMSE combined application was beneficial to early detection of cognitive dysfunction in COPD patients, and MoCA was more sensitive than MMSE.