摘要
目的探讨脑卒中患者洛文斯顿作业疗法认知评定量表（LOTCA）在血管性认知功能障碍（VCI）评定中的应用价值。方法按简易精神状态检查（MMSE）划分认知障碍标准，选取脑卒中认知功能障碍患者（认知障碍组）、脑卒中无明显认知障碍患者（脑卒中对照组）和健康志愿者（健康对照组）各30例。3组间一般情况相匹配，分别进行MMSE和LOTCA评定，比较LOTCA和MMSE的评定结果，分析两者相关性。结果认知障碍组LOTCA总分和MMSE总分呈高度正相关（r=0．934，P〈0．001），LOTCA各项与MMSE各项间也均呈一定的正相关性（P〈0．01）；认知障碍组总分及所有各亚项评分均明显低于脑卒中对照组和健康对照组（P〈0．01），尤以思维运作、定向力、视运动组织亚项受累最明显；脑卒中对照组思维运作、视运动组织、注意力、定向力、空间知觉评分均明显低于健康对照组（P〈0．01），以思维运作和视运动组织降低为著。结论LOTCA与M恤sE具有相关性，LOTCA能较MMSE更早期和全面的评定VCI，适合非痴呆型血管性认知功能障碍（VCIND）的评定。
Objective To compare the assessment results of Loewenstein occupational therapy cognitive assessment （LOTCA） and mini-mental state examination（MMSE） in stroke patients, and to analyze the correlation between the two assessments and to explore the applicable values of LOTCA in assessing vascular cognitive function impairment （ VCI）. Methods According to the diagnostic standard of cognitive impairment with MMSE, thirty stroke patients with cognitive imtlairmerit were selected as cognitive impairment group, thirty stroke patients without markedly cognitive impainent as stroke control group, and thirty normal subjects served as normal control group. All the subjects＇ age, gender and level of education were matched in the three groups. All the subjects were as-sessed with LOTCA,and MMSE. Results The total scores of LOTCA had high positive correlation with the total scores of MMSE in cognitive impairment group （r = 0. 934, P 〈 0.01 ） , the correlations were also found between every subitems of LOTCA and those of MMSE （ P 〈 0.01 ）. The total scores and the scores of sub-items of LOTCA in cognitive impairment group were significantly lower than those in stroke control group and were those in normal control group （ P 〈 0.01 ） , particularly lower scores in LOTCA subitems of thinking operations, orientation, visuomotor organization. The scores of subitems of LOTCA, including thinking operations, visuomotor organization, attention, Orientation, spatial perception were all significantly lower in stroke control group than those in normal control group（ P 〈 0.01 ） , especially in thinking operations and visuomotor organization sub-items. Conclusions Correlations were found between LOTCA and MMSE. Compared to MMSE, LOTCA could detect vascular cognitive function impairment earlier and is much more comprehensive, so it is suitable to assess vascular cognitive impairment patients with no dementia.
出处
《中华物理医学与康复杂志》
CAS
CSCD
北大核心
2012年第1期26-30,共5页
Chinese Journal of Physical Medicine and Rehabilitation
关键词
脑卒中
洛文斯顿认知评定量表
简易精神状态检查
血管性认知功能障碍
Stroke
Loewenstein occupational therapy cognitive assessment
Mini-mental state examina-tion
Vascular cognitive function impairment
