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目的初步探讨认知障碍简明评价表(cognitive-12scale,Cog-12)在筛查慢性肾衰竭(chronic renal failure,CRF)患者认知功能障碍中的应用价值。方法招募南京地区四所三甲医院肾内科门诊及住院治疗的临床确诊的CRF患者共171例,按认知障碍诊断标准分为认知功能正常组、轻度认知功能障碍组(MCI)及痴呆组。采用Cog-12量表通过询问照料者对患者进行测评,采用Addenbrooke改良认知评估量表(Addenbrooke cognitive examination revised,ACE-R)对各组患者进行神经心理评估,分析Cog-12量表、简易智能筛查量表(mini-mental state of examination,MMSE)与ACE-R结果的相关性。结果 (1)CRF患者Cog-12量表评分与ACE-R评分呈显著负相关(r=-0.909),且相关程度显著优于MMSE(r=0.847)。(2)Cog-12对于CRF患者MCI的识别能力明显优于AD8(AUCCog-12=0.834;AUCAD8=0.802),在界值设定为5/6时,Cog-12量表对MCI的筛查效果最佳(敏感度0.769、特异度0.650、约登指数0.419)。结论 Cog-12量表可有效检测CRF患者的认知功能损伤,同时易于发现早期轻度的认知功能损伤,可用于临床CRF患者认知功能的筛查。
Objective To investigate the value of cognitive-12scale (Cog-12) in the screening of cognitive dysfunction in patients with chronic renal failure (CRF). Methods A total of 171 clinically diagnosed CRF patients from outpatients and inpatients with nephrology outpatient and inpatient treatment at four top three hospitals in Nanjing area were enrolled. According to the diagnostic criteria of cognitive impairment, they were divided into normal cognitive function group, mild cognitive impairment group (MCI) and dementia group. Patients were assessed by interrogation of caregivers using the Cog-12 scale, neuropsychological assessment of each group using the Addenbrooke cognitive examination revised (ACE-R), analysis of the Cog-12 scale, and summary Correlation of mini-mental state of examination (MMSE) with ACE-R results. Results (1) There was a significant negative correlation between Cog-12 scale and ACE-R score in CRF patients (r = -0.909), and the correlation was significantly better than MMSE (r = 0.847). (2) The ability of Cog-12 to recognize MCI in patients with CRF was significantly better than that of AD8 (AUCCog-12 = 0.834; AUCAD8 = 0.802). When the cutoff value was set at 5/6, Cog- The best effect (sensitivity 0.769, specificity 0.650, Youden index 0.419). Conclusion The Cog-12 scale can effectively detect cognitive impairment in patients with CRF, and can easily detect early mild cognitive impairment, which can be used for the screening of cognitive function in clinical CRF patients.