本文選題：慢性腎臟病　切入點：認(rèn)知損傷　出處：《實用醫(yī)學(xué)雜志》2017年05期

【摘要】：目的:探討Addenbrooke改良認(rèn)知評估量表(ACE-R)在慢性腎臟病(CKD)患者認(rèn)知功能評估中的應(yīng)用。方法:招募南京地區(qū)4家綜合醫(yī)院2014年3-7月腎內(nèi)科門診及住院治療的臨床確診的CKD患者共205例,采用ACE-R評估其認(rèn)知功能,并對結(jié)果進(jìn)行比較分析。結(jié)果:(1)NC-NCDs組(89.18±4.80)、Mild-NCDs(77.28±5.80)組和Major-NCDs組(55.90±10.90)之間ACE-R水平相比差異有統(tǒng)計學(xué)意義(F=292.28,P0.01),組間兩兩比較差異有統(tǒng)計學(xué)意義(均P0.01);(2)ACE-R(AUC=0.944,P0.01)對Mild-NCDs患者的識別能力顯著優(yōu)于MMSE(AUC=0.777,P0.01);(3)ACE-R總分區(qū)別NC-NCDs和Mild-NCDs患者最佳截斷值為83/84(敏感度88.00%,特異度85.90%,約登指數(shù)0.739),區(qū)別Mild-NCDs和Major-NCDs患者最佳截斷值為71/72(敏感度89.70%,特異度96.10%,約登指數(shù)0.858)。結(jié)論:ACE-R對CKD患者認(rèn)知損傷不同嚴(yán)重程度具有較好的區(qū)分能力,同時可有效識別早期輕度認(rèn)知功能損傷,適合臨床推廣用于CKD患者認(rèn)知功能的評估與研究。
[Abstract]:Objective: to investigate the application of Addenbrooke modified cognitive assessment scale (ACE-R) in the evaluation of cognitive function in patients with chronic kidney disease (CKD). Methods: 205 patients with CKD were recruited from 4 general hospitals in Nanjing from March to July 2014. The cognitive function was evaluated by ACE-R. Results compared with Major-NCDs group (55.90 鹵10.90), there was a significant difference in ACE-R level between the two groups (P < 0.01). There was significant difference between the two groups (all P0.01ACE-RAUC 0.944P0.01). The recognition ability of Mild-NCDs patients was significantly better than that of MMSEC0.777P0.01P0.01ACE-3ACE-R. The best truncation value of differentiating NC-NCDs and Mild-NCDs patients is 83 / 84 (sensitivity 88.00, specificity 85.90), Yorden index 0.739 ~ (g), and differentiating Mild-NCDs and Major-NCDs patients the best truncation value is 71 / 72 (sensitivity 89.70, specificity 96.10, Jordan index 0.8580.Conclusion: 1. 0% ACE-R has different severity of cognitive impairment in CKD patients. Degree has a good ability to distinguish, At the same time, it can effectively identify early mild cognitive impairment, which is suitable for clinical application in the evaluation and study of cognitive function in patients with CKD.
【作者單位】： 南京醫(yī)科大學(xué)附屬江寧醫(yī)院神經(jīng)內(nèi)科;
【分類號】：R692;R749.2

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