《中国康复理论与实践》

《中国康复理论与实践》 ›› 2014, Vol. 20 ›› Issue (6): 554-557.

• 论文 • 上一篇    下一篇

脑卒中恢复期认知障碍的蒙特利尔认知评估及其影响因素的研究

刘剑1，山磊2,3，张小年2,3，崔利华2,3   

  1. 1.煤炭总医院康复医学科，北京市100028；2.首都医科大学康复医学院，北京市100068；3.中国康复研究中心北京博爱医院神经康复科，北京市100068
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2014-06-25 发布日期:2014-06-25

Characteristics and Related Factors of Montreal Cognitive Assessment for Cognitive Impairment after Stroke

LIU Jian, SHAN Lei,ZHANG Xiao-nian, et al.   

  1. Department of Rehabilitation, China Meitan General Hospital, Beijing 100028, China
  • Received:1900-01-01 Revised:1900-01-01 Published:2014-06-25 Online:2014-06-25

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摘要： 目的探讨脑卒中患者蒙特利尔认知评估量表(MoCA)评分的特点，分析年龄、昏迷与否、损伤侧、损伤部位等因素对MoCA总分和各分项评分的影响。方法记录135 例脑卒中患者一般资料，并使用MoCA进行评分，分析结果。结果患者在延迟回忆、抽象、语言、视空间与执行功能方面平均得分相对较低，而在命名、注意、定向方面得分相对较高。年龄较大患者与年龄较小患者在MoCA总分、注意、语言、延迟回忆和定向得分上有显著性差异(P<0.05)。发生昏迷的患者与未发生昏迷的患者在总分、视空间与执行功能、注意、定向等项目上得分有显著性差异(P<0.05)。病变侧在左侧的患者与在右侧的相比，总分、注意、语言、抽象和延迟回忆、定向得分上有显著性差异(P<0.05)。与基底节损伤相比，额叶损伤在总分、注意、抽象和延迟回忆得分上有显著性差异(P<0.05)，额、颞、顶叶损伤在总分、命名、抽象和延迟回忆得分上有显著性差异(P<0.05)。结论MoCA可以在一定程度上反映脑卒中患者认知障碍的程度，年龄、是否发生昏迷、损伤病变侧和损伤部位会影响患者的认知障碍程度。

关键词: 脑卒中, 蒙特利尔认知评估量表, 认知障碍, 康复

Abstract: Objective To investigate the characteristics of Montreal Cognitive Assessment (MoCA) and analyze the influence of age, coma or not, injury side, and injury area on the scores of MoCA. Methods 135 stroke patients were evaluated with MoCA. Results The scores were poor in delayed recalling, abstraction, verbal fluency, view space and executive function, and were less poor in naming, attention and orientation. There was significantly difference in the total score, attention, verbal fluency, delayed recalling and orientation of MoCA between older and younger patients (P<0.05). There was significantly difference in the total score, view space and executive function, attention, orientation between patients with coma and without coma (P<0.05). There was significantly difference in the total score, attention, verbal fluency, abstraction, delayed recalling and orientation between thoses with left side injury and right side injury (P<0.05). Compared with basal ganglia injury, front lobes injury tended to impact the total scores, attention, abstraction and delayed recalling (P<0.05); frontal, temporal and parietal lobes tended to impact the total score, naming, abstraction and delayed recalling (P<0.05). Conclusion The total scores of MoCA do reflect the cognitive impairment in patients with stroke, while the age, coma or not, injury side and injury area of the brain may impact the cognitive impairment in patients.

Key words: stroke, Montreal Cognitive Assessment, cognitive impairment, rehabilitation