3分法画钟测验对区别轻中度血管性痴呆的作用探讨

摘要

Objective It is to explore identification role of clock drawing test ( CDT ) on mild and moderate vascular dementia ( VD ) patients. Methods 335 cases of VD patients were collected and their history taking and neuropsychological scale tests were conducted. The patients were divided into the mild VD group of 182 cases and moderate VD group of 153 cases according to their scores of clinical dementia rating scale( CDR ). The trichotomy CDT scores were compared between the two groups to analyze whether there were differences in CDT score, correlation between CDT, Chinese version of the mini-mental state examination( MMSE ) and CDR, and the sensitivity and specificity of trichotomy CDT in distinguishing mild VD and moderate VD. Results Significant differences ( Z = - 10. 489, P <0.01 ) were found in trichotomy CDT score between mild VD group and moderate VD group; there' s a strong correlation between CDT and MMSE as well as CDR, with the Spearman correlation coefficient 0. 694 and - 0. 674 respectively ( P < 0. 01 ). Meanwhile, trichotomy CDT has certain sensitivity ( 69. 8% ) and specificity ( 83. 0% ) on the differentiation between mild VD and moderate VD. Conclusion Trichotomy CDT is of some help for the judgment of dementia severity and the differentiation of mild and moderate VD patients. However, its ability to identify is limited and cannot be used alone.%目的 探讨3分法画钟测验(CDT)对轻中度血管性痴呆(VD)的鉴别作用.方法 收集轻、中度VD患者335例,进行病史采集及神经心理量表测试,根据患者临床痴呆评定量表(CDR)评分情况,将其分为轻度VD组182例及中度VD组153例.2组间进行3分法CDT评分比较,分析2组在CDT分值上有无差异,CDT与中文版简易智能量表(MMSE)、CDR有无相关性以及3分法CDT对区分VD轻度与中度的敏感性和特异性.结果 3分法CDT评分在轻度VD组及中度VD组间比较有显著性差异(Z=-10.489,P＜0.01);CDT与MMSE及CDR有较强相关性,Spearman相关系数分别为0.694和-0.674(P＜0.01);同时,3分法CDT对区别轻度VD和中度VD有一定的敏感性(69.8%)和特异性(83.0%).结论 3分法CDT对判断痴呆的严重程度,区别轻、中度VD患者有一定帮助,但其鉴别能力有限,不适宜单独使用.