目的:分析影响简易精神状态量表(Mini-Mental State Examination,MMSE)筛查效度的因素,为建立MMSE得分的常规模型、修正并完善现行MMSE筛查标准提供依据。方法:从中国老年健康影响因素跟踪调查(Chinese Longitudinal Healthy Longevity ...目的:分析影响简易精神状态量表(Mini-Mental State Examination,MMSE)筛查效度的因素,为建立MMSE得分的常规模型、修正并完善现行MMSE筛查标准提供依据。方法:从中国老年健康影响因素跟踪调查(Chinese Longitudinal Healthy Longevity Survey,CLHLS)队列中得到符合纳入标准的19 117名正常老年人和137名痴呆患者的MMSE测试结果;用工作特征曲线下面积(area under the curve,AUC)及效度指标对比MMSE各类临界值的筛查效度;用多元线性回归比较正常和痴呆人群的MMSE得分的影响因素的差异;描述正常与痴呆老年人MMSE得分随年龄、性别的变化趋势及差别。结果:MMSE量表的AUC值≥0.75(P<0.05);正常人群MMSE得分随年龄增长呈非线性下降(男:R2=0.924,P<0.05;女:R2=0.951,P<0.05);随受教育程度增加呈非线性上升(男:R2=0.948,P<0.05;女:R2=0.859,P<0.05);女性MMSE平均得分低于同龄男性,且下降速度更快(女性偏回归系数的95%置信区间与男性偏回归系数的95%置信区间不重叠)。不论男女,痴呆老年人的MMSE得分均低于正常老年人(男:Z分数差值:-1.573,P<0.05;女:Z分数差值:-1.222,P<0.05);MMSE得分随年龄增加下降速度似乎比正常老年人更快(痴呆人群偏回归系数的95%置信区间包含正常人群偏回归系数的95%置信区间)。结论:CLHLS中的MMSE量表筛查效度不受文化程度影响,本研究针对影响MMSE筛查效度的可能因素及其影响程度的探讨得出,性别、年龄、视力和居住地是具有鉴别效度的因素,可作为MMSE量表的辅助工具筛查痴呆人群。展开更多
Objective： To observe the clinical efficacy of electroacupuncture（EA） on Alzheimer＇s disease（AD）.Methods： A total of 50 AD patients were randomly allocated into a Western medication（WM） group（n=25） and an a...Objective： To observe the clinical efficacy of electroacupuncture（EA） on Alzheimer＇s disease（AD）.Methods： A total of 50 AD patients were randomly allocated into a Western medication（WM） group（n=25） and an acupuncture plus medication（APM） group（n=25）. Patients in the WM group took oral huperzine A capsules. In addition to huperzine A capsules, patients in the APM group also received EA at Shenting（GV 24）, Baihui（GV 20）, Dazhui（GV 14）,Fengfu（GV 16）, Mingmen（GV 4） and Yongquan（KI 1）. The needles on the above points were connected to G6805-Ⅱelectric stimulator [3 pairs： Shenting（GV 24） and Baihui（GV 20）; Dazhui（GV 14） and Fengfu（GV 16）; and bilateral Yongquan（KI 1）]. The needles were retained 25 min. The treatment was done once a day, and 10 times made up a course of treatment.The patients received a total of 3 treatment courses. There was a 3-day interval between two courses. The mini-mental state examination（MMSE） and Hasegawa dementia scale revised（HDS-R） were conducted before and after treatment. The clinical efficacies were evaluated when the treatment was completed.Results： Before treatment, there were no between-group statistical differences in MMSE and HDS-R scores（both P〈0.05）.After treatment, the MMSE and HDS-R scores in the APM group were significantly higher than those in the WM group（both P〈0.05）. The total effective rate in the APM group was 88.0%, versus 76.0% in the WM group, showing a statistical difference（P〈0.05）.Conclusion： EA is effective for AD and can improve clinical symptoms in AD patients.展开更多
文摘目的:分析影响简易精神状态量表(Mini-Mental State Examination,MMSE)筛查效度的因素,为建立MMSE得分的常规模型、修正并完善现行MMSE筛查标准提供依据。方法:从中国老年健康影响因素跟踪调查(Chinese Longitudinal Healthy Longevity Survey,CLHLS)队列中得到符合纳入标准的19 117名正常老年人和137名痴呆患者的MMSE测试结果;用工作特征曲线下面积(area under the curve,AUC)及效度指标对比MMSE各类临界值的筛查效度;用多元线性回归比较正常和痴呆人群的MMSE得分的影响因素的差异;描述正常与痴呆老年人MMSE得分随年龄、性别的变化趋势及差别。结果:MMSE量表的AUC值≥0.75(P<0.05);正常人群MMSE得分随年龄增长呈非线性下降(男:R2=0.924,P<0.05;女:R2=0.951,P<0.05);随受教育程度增加呈非线性上升(男:R2=0.948,P<0.05;女:R2=0.859,P<0.05);女性MMSE平均得分低于同龄男性,且下降速度更快(女性偏回归系数的95%置信区间与男性偏回归系数的95%置信区间不重叠)。不论男女,痴呆老年人的MMSE得分均低于正常老年人(男:Z分数差值:-1.573,P<0.05;女:Z分数差值:-1.222,P<0.05);MMSE得分随年龄增加下降速度似乎比正常老年人更快(痴呆人群偏回归系数的95%置信区间包含正常人群偏回归系数的95%置信区间)。结论:CLHLS中的MMSE量表筛查效度不受文化程度影响,本研究针对影响MMSE筛查效度的可能因素及其影响程度的探讨得出,性别、年龄、视力和居住地是具有鉴别效度的因素,可作为MMSE量表的辅助工具筛查痴呆人群。
基金supported by Key Research Project of Science and Technology Bureau of Leshan Town,No.15ZDYJ0150~~
文摘Objective： To observe the clinical efficacy of electroacupuncture（EA） on Alzheimer＇s disease（AD）.Methods： A total of 50 AD patients were randomly allocated into a Western medication（WM） group（n=25） and an acupuncture plus medication（APM） group（n=25）. Patients in the WM group took oral huperzine A capsules. In addition to huperzine A capsules, patients in the APM group also received EA at Shenting（GV 24）, Baihui（GV 20）, Dazhui（GV 14）,Fengfu（GV 16）, Mingmen（GV 4） and Yongquan（KI 1）. The needles on the above points were connected to G6805-Ⅱelectric stimulator [3 pairs： Shenting（GV 24） and Baihui（GV 20）; Dazhui（GV 14） and Fengfu（GV 16）; and bilateral Yongquan（KI 1）]. The needles were retained 25 min. The treatment was done once a day, and 10 times made up a course of treatment.The patients received a total of 3 treatment courses. There was a 3-day interval between two courses. The mini-mental state examination（MMSE） and Hasegawa dementia scale revised（HDS-R） were conducted before and after treatment. The clinical efficacies were evaluated when the treatment was completed.Results： Before treatment, there were no between-group statistical differences in MMSE and HDS-R scores（both P〈0.05）.After treatment, the MMSE and HDS-R scores in the APM group were significantly higher than those in the WM group（both P〈0.05）. The total effective rate in the APM group was 88.0%, versus 76.0% in the WM group, showing a statistical difference（P〈0.05）.Conclusion： EA is effective for AD and can improve clinical symptoms in AD patients.
文摘目的探讨颈动脉粥样硬化对轻度认知功能损害（mild cognitive impairment，MCI）的影响。方法2006年11月至2007年9月单纯随机抽选1886名广州市50岁或以上，自报未患有脑卒中、心肌梗死、肺心病及恶性肿瘤等重大慢性疾病的相对健康的中老年人进行MCI测试和颈动脉彩色超声多普勒检查，以简易精神状态检查（Mini Mental State Examination，MMSE）及10个单词延迟记忆测试（10-word list learning task，CWL）得分和颈总动脉内膜一中膜厚度（IMT）作为评价指标。结果（1）本研究共检出MCI300例，患病率为15．9％。男女之间患病率差异无统计学意义。（2）CWI。得分随年龄、吸烟率、收缩压、腹围和低密度脂蛋白的升高而降低，随教育程度、体力活动和高密度脂蛋白上升而增加；而MMSE则与吸烟、体力活动、腹围和脂蛋白水平无明显相关。（3）在校正了多种潜在混杂因素后，IMT的增加均与CWL（β=-1．05，95％CI：-1．73～-0．36）和MMSE分数（p=-0．95，95％CI：-1．67～-0．23）的下降呈线性相关（P〈0．01）。（4）在校正了年龄、性别、教育、运动、吸烟、腹围、收缩压和高密度及低密度脂蛋白后，MCI患者相对非MCI者的平均IMT显著增加（0．76mm与0．74mm，F=6．9，P〈0．01）。结论颈动脉IMT增加与MCI的严重程度呈线性相关，与MCI的发生、发展关系密切。
