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- 2018
肌萎缩侧索硬化症患者执行功能损害的量表优化
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Abstract:
摘要：目的 筛查可反映肌萎缩侧索硬化(ALS)患者执行功能损害的量表，并确定其参考值。方法 通过对比ALS患者和对照组蒙特利尔认知评估(MOCA)执行功能、快速词汇测验(rapid verbal retrieval, RVR)、韦氏成人智力测验(Wechsler Adult Intelligence Scale, WAIS)数字广度测验和额叶功能评定表(frontal assessment battery, FAB)评分，确定患者有无执行功能损害，并通过ROC曲线从WAIS数字广度、RVR(动物、水果、蔬菜)、FAB、“大”组词和MOCA执行亚项7项量表中筛选出敏感的执行功能损害的量表。结果 病例组MOCA、RVR、WAIS数字广度测验、FAB评分明显低于对照组(P<0.05)，其中MOCA执行功能、RVR(动物、蔬菜、水果)评分、WAIS数字广度测验中顺向和逆向评分、FAB中概念化能力、“大”组词、程序性控制、对干扰敏感性、抑制性控制评分明显低于对照组(P<0.05)，而“发”组词和FAB量表中自主性抓握在两组间差异无明显统计学意义(P>0.05)。对ALS执行功能障碍测查，诊断效能从高到低依次为WAIS数字广度、RVR(动物)、FAB、“大”组词、RVR(水果)、RVR(蔬菜)和MOCA执行功能。结论 26.74%ALS患者存在执行功能障碍，筛查ALS患者执行功能障碍时，WAIS数字广度、RVR(动物)、FAB有较高诊断效能。
ABSTRACT: Objective To screening scales that can reflect the executive function impairments in amyotrophic lateral sclerosis (ALS) patients and determine their reference value. Methods We compared MOCA executive function, rapid verbal retrieval (RVR), Wechsler Adult Intelligence Scale (WAIS) and Frontal Assessment Battery (FAB) between ALS patients and control subjects to determine whether ALS patients have executive dysfunction. ROC curve was adopted to screen out the sensitive executive scales from WAIS, RVR (animals), RVR (fruits), RVR (vegetables), FAB, words beginning with "da" and MOCA executive function. Results The scores of MOCA executive function, RVR, WAIS and FAB were lower in ALS patients than in control subjects (P<0.05). Compared with controls, ALS patients had poor performance in MOCA executive function, RVR (animals), RVR (fruits), RVR (vegetables), forward and backward in WAIS, conceptualization, uttering words beginning with "da", procedural control, sensitivity to interference, inhibitory control in FAB (P<0.05). However, there were not significant differences in words beginning with "fa" and autonomy in FAB (P>0.05). In order to detect executive dysfunction in ALS, the diagnostic efficacy was WAIS, RVR (animals), FAB, words beginning with "da", RVR (fruits), RVR (vegetables), and MOCA executive function in descending order. Conclusion 26.74% of the ALS patients have executive dysfunction. When executive dysfunction is screened in ALS patients, WAIS, RVR (animal), FAB have high diagnostic efficacy
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