銆愭憳瑕併?/strong> 鐩殑錛氬垎鏋愭甯歌佷漢緇?NA),鐫變笉鍚屾埆銆佸勾榫勤銆佹暀鑲茬▼搴﹀垎灞傜殑鑰佸勾鎴愬紲炵粡蹇冪悊嫻嬮獙錛圔CAI錛夌殑鐗圭偣鍙奛A涓庤交搴「鋨姛鑳芥崟瀹籌紙MCI錛夎佷漢鐨澿CAI鐨動壒鐐癸紱鎺三儲瀵圭輗鍛嗙殑棰勤祴鍜屾棭鏈熻瘖鏂殑浠峰箋傛柟娉曪細閱囩敤妯柇闈三爺絀訛紝瀵硅窘瀹侀儴鍒骨湴鍖?0佷互涓匊佷漢榪瀆鑰佸勾鎴愬蹇冪悊嫻嬮獙銆傜粨鏋滐細BCAI瀵規甯歌佷漢銆丮CI鐨勫垽瀹氬噯紜巼楂樸侻CI緇蹺芽NA緇蹺莿闀碆CAI鎵鏈綏崟鍥豺瓙嫻嬮獙鎴愮嘩鏈倨樉钁楁樊寮骨紱姝ｅ父鑰佷漢緇勤寧鎖欒偛紼嬪害鍒嗙▼銆乄HO錛廈CAI鐨勫夬閮ㄥ崟鍥豺瓙嫻嬮獙鎴愮嘩鏈倨樉钁楁樊寮傘傜粨璁猴細MCI緇勤湁澶氡柟闈三殑璁煡鍔熻始鎹熷錛屾甯歌佷漢緇勤暀鑲插偍澶囪秺楂楤CAI鎴愮嘩瓚婂銆儘CAI瀵池CI鏃┼湡棰勤祴鏈夎偗瀹氫綔鐢ㄣ?
銆愬剮閿瘝銆?/strong> 鑰佸勾鎴愬紲炵粡蹇冪悊嫻嬮獙錛淚甯鎬漢錛瀆交搴「鋨姛鑳芥崟瀹?/p>
鐩墠鎴賊浗涓庤侀緞鐩稿剮闀鏃祩鏄庢樉錛屻佸勾釤村惰鍙匊佸勾杞誨害璁煡鍔熻始鎹熷鑰呰秺鏉秺澶氾紝宸插彈鍒扮浼氧殑楂樺害閱嶈銆傛湰鏂囧鑰佸勾濱哄渜鏂囧寲紼嬪害銆佸勾榫勩佹埆鏂歸潰錛岸挨鍏舵槸紲炵粡蹇冪悊鍙匊涓虹殑鍙樺寲鏂歸潰鏉掃璁ㄨ佸勾濱洪棶棰樸傝揪鍒版棭鏈熼嫻嬶紝寤剁紦釤村惰鐨動洰鐨勩?/p>
1 瀵硅薄鍜屾柟娉?/strong> 1.1 瀵硅薄 鍙楄瘯鑰喋潎涓烘湰甯備袱鎵鎖侀櫌鍜屻佸共閮ㄥ矓閫浼?0佷互涓婄殑鑰佷漢銆傛甯哥粍鐨劇佷漢韜綋鍋悍錛屾棤涓噸韜綋鼎劇棶錛岸苟涓旇始閰嶅悎嫻嬭瘯 銆傚靉緇勤爣鍑嗭細(1)鏍規嵁騫撮緞60~69併?0~79併?0佷互涓婂垎涓轟笁緇徹紱錛?錛倨寧涓夌鍙楁暀鑲茬▼搴﹀垎涓烘枃鐩層佸曤瀛︼紙鎖欒偛騫撮檺≤6騫達級鍙婁腑瀛︽守浠芄錛壟暀鑲插勾闄愶帔6騫達級錛涳紙3錛?2渚嬫甯歌佷漢緇動敺濂沖悇36鍚圮紝涓夌粍鐫倨瘮渚嬪垎閰嶅潎絳齋傚紓甯哥粍錛屻交搴「鋨姛鑳芥崟瀹寵?2濱恆?/p>
1.2 鏂規磣 閱囩敤宸哄鈶犵畝鏄庢櫤鍔兌姘鎬佹鏌紙MMSE錛變負絳淚煡宸哄錛?錛?錛屾寧鍙楁暀鑲茬▼搴︼紙MMSE錛倨誨垎鞝錛屾枃鐩?ge;18鍒嗭紱灝忏≥20鍒嗭紱涓浠芄≥25鍒嗕負姝ｅ父鑰佸勾濱恆傚叾瀹林綆濱庡悇欏瑰垎鍊艱喋垪涓哄紓甯哥粍銆滀忪鐫變芄嫻風簿紲炱崼鐢爨腑蹇江夌敤鐨劇佸勾鎴愬紲炵粡蹇冪悊嫻嬮獙錛圔attery of Cognitive Assessment Instruments錛靡CAI錛變負鍩虹錛?錛?錛?榪瀆嫻嬮獙錛岸唴瀹瑰寘鎷紙1錛變竴鑸祫鏂欙紱錛?錛綏惉瑙夎瘝奼囷紱錛?錛綏垎綾伙紱錛?錛倨敞閿嫻嬮獙錛涳紙5錛夎繡鍔ㄦ祴楠岋紱錛?錛夎瑙夎鯨璁姛鑳斤紱錛?錛夎瘝奼囧歡榪熷洖蹇嗭紱錛?錛夌└闀寸粨鏋徹紱錛?錛夎綽綰跨瓅榪瀆璇勫畾銆滀憿鍏朵曲閱忚〃錛氡棩甯哥敓媧昏始鍔溳噺琛紙ADL錛多薊1錛?銆傝瘎瀹氡棩甯哥敓媧葷殑鑷悊鑳藉姏錛淚諱綋閫鍖栭噺琛紙GDS錛夎瘎瀹氡諱綋閫鍖栫姘鍐碉薊1錛?銆滀懀鐫囧鎵嬪淅錛屾祴楠岸浘鐗淵竴濂楋薊2錛?錛?銆?/p>
2 緇撴灉 棣枻廳瀵?0佷互涓匊佷漢鐢∕MSE絳溳多紝鐫綏靉緇勤爣鍑骨垎涓烘甯哥粍錛圢A錛變芽杞誨害璁煡鍔熻始緇徹紙MCI錛齋孛A緇徹紝鍙楁暀鑲插勾闄愯秺楂樿他紝鍏禡MSE銆丄DL銆丟DS銆佸叴瓚ｅ垎鍊煎強BCAI鍒嗛」嫻嬮獙鍧回珮錛兌敺濂蟲埆涓璦鑳藉姏錛屻綽綰挎祴楠出敺鎬濱庡鎬紱鐫綏勾榫動粍緇熻涓敞閿嫻嬮獙錛屻瘝奼囧洖蹇嗕綆騫撮緞緇勫濱庨珮騫撮緞緇徹紝涓斿潎鏈夌粺璁〞鎰仁菎銆侻CI緇蹺芽姝ｅ父緇劇佷漢緇動溮姣旓紝鍏禡MSE銆丄DL銆丟DS銆佸叴瓚ｅ垎鍊煎強BCAI嫻嬮獙鍚勯」鍒骨煎潎鏄庢樉浣庝簬NA鑰佷漢錛岸樊寮傛湁鏄捐憲鎬傜敳姝湅鏉槥鍙婃暀鑲詫紝鎖晃珮鍙楁暀鑲插勾闄愶紝鑳芥彁楂樹漢鍙ｇ礌璐紝鑰屼笖鑳藉噺灝戛守鎺ㄨ繜釤村惰鐨勫發鐢焜?/p>
2.1 72渚婲A鑰佷漢騫撮緞銆佹埆銆佹枃鍖栫▼搴﹀垎甯太琛?銆傝〃1 72渚婲A鑰佷漢騫撮緞銆佹埆銆佹枃鍖栫▼搴﹀垎甯?/p>
2.2 NA鑰佷漢鐨風MSE銆丄DL銆丟DS銆佸叴瓚ｅ箍搴﹀強鍙樺寲瑙佽〃2銆傝〃2 NA鑰佷漢鐨風MSE銆丄DL銆丟DS銆佸叴瓚ｅ箍搴︽瘮杈寫柟宸垎鏋愶紝*錛歅錛?.05錛?*錛歅錛?.01 鐫變笉鍚屾埆銆佸勾榫勤銆佹暀鑲茬▼搴﹀垎灞傜殑MMSE銆丄DL銆丟DS銆佸叴瓚ｅ箍搴﹀垎鍊肩粨鏋滃琛?鎵紺猴細MMSE銆佸叴瓚ｅ箍搴︽昏祩鍔跨敺鎬珮濱庡鎬紝浣庡勾榫勤楂樹簬楂樺勾榫動粍錛岸挨鍏墮殢鎖欒偛縐搫鐨勫搴︼紝鍛壟樉钁楁芄鍗囪祩鍔褲傝歡DL銆丟DS鍛堜笅闄嶈祩鍔褲?/p>
2.3 姝ｅ父鑰佷漢BCAI嫻嬮獙鍒嗛」姣旇緝瑙佽〃3銆?/p>
鐢辮〃3鍙煡錛屾寧涓嶅俔鎬埆銆佸勾榫勩佸彈鎖欒偛紼嬪害鍒骨眣WHO鈭旴CAI鍚勫崟鍥豺瓙錛岄殢鐫鍙楁暀鑲茬▼搴︾殑澧為珮鍚勫崟鍥豺瓙鍊煎潎鍛壟樉钁楁芄鍗囥傝屾埆銆佸勾榫動粍涓櫎榪炵嚎銆佽瘝奼淵袱鍗曞洛瀛愭湁鏄捐憲鎬錛岸叾浠枻悇鍗曞洛瀛愬憟鎬諱綋涓婂崌瓚嬪娍錛屾棤鏄捐憲鎬傜敳姝張榪涗竴姝瘉鏄峬紝鎖晃珮鏂囧寲鞝犺川鐨勯噸瑕佹?/p>
2.4 姝ｅ父鑰佷漢銆佽交搴「鋨殰紕嶇殑MMSE銆丄DL銆丟DS銆佸叴瓚ｅ箍搴﹀彉鍖栫粨鏋滆琛?銆備粠琛?鍙互鐪嬪嚭MMSE銆丄DL銆丟DS銆佸叴瓚ｅ箍搴︽柟闈袱鑰呬莿闀村潎鏈夐珮搴︾殑鏄捐憲鎬樊寮傘傚挨鍏禡MSE鍒骨肩殑涓嬮檷錛堥檷浣峬級錛岸螭浣滀負鏃┼湡絳溳夎交搴「鋨殰紕嶅強釤村惰鐨勯珮鍗變漢緹殑鐫呸爣錛岸叾浠栦笁鏂歸潰涔熸湁杈呬綈浣滅敤銆傝〃3 姝ｅ父鑰佷漢BCAI嫻嬮獙鍒嗛」姣旇緝琛? 姝ｅ父鑰佷漢銆佽交搴「鋨殰紕嶇殑MMSE銆丄DL銆?GDS銆佸叴瓚ｅ箍搴︽瘮杈寫柟宸垎鏋愶細**:P錛?.01銆?/p>
2.5 姝ｅ父鑰佷漢錛屻交搴「鋨殰紕嶇殑BCAI嫻嬮獙鐨勫崟鍥豺瓙鍙樺寲瑙佽〃5銆傝〃5 姝ｅ父鑰佷漢銆佽交搴「鋨殰紕嶇殑BCAI嫻嬮獙鐨勫崟鍥豺瓙鍙樺寲浠庤〃5鍙戠幫錛屾甯哥粍涓嶮CI緇勫渜BCAI嫻嬮獙涓紝鍏ㄩ儴鍗曞洛瀛愮粨鏋滃潎鏈倨樉钁楁樊寮傘?/p>
3 璁ㄨ 鐩墠鏈綏剮鑰佸勾濱鴻鋨姛鑳界殑鐮旂┐錛屻秺鏉秺闆嗕腑濱庡杞誨害璁煡鍔熻始鎹熷鍙婄輗鍛嗛珮鍗變漢緹殑棰勤祴鏂歸潰錛?錛?錛岸挨鍏惰交搴「鋨崟瀹籌紙MCI錛倨槸榪賊嚑騫磋佸勾綺劇鍗敓棰骨煙鐨蹺竴涓爺絀剁儹鐐癸薊5錛?銆傛湰鏂回夌敤鐨劇佸勾鎴愬紲炵粡蹇冪悊嫻嬮獙鍙畚MSE絳多紝鏄浗闄呴氧敤鐨蹺芽鍥藉唴澶栨湁鍏崇爺絀跺哄鏈綏螭姣旀?/p>
鏈爺絀剁粨鏋滆〃鏄峬紝姝ｅ父鑰佷漢鐨澿CAI鍦ㄤ笉鍚出殑鎬埆銆佸勾榫勤銆佹暀鑲茬▼搴」輗鏈夌潃鍖哄埆銆傝櫧鎬諱綋鍒骨煎憟涓婂崌瓚嬪娍錛屼絾鍦ㄦ埆銆佸勾榫勤錛堣綽綰誇芽璇嶆眹鍗曞洛瀛愶級闀存棤鏄捐憲鎬樊寮傘傝繖涓庢湁鍏蟲枃錏姤閬划溮鎮栵紝鏈綏緟榪涗竴姝掃璁ㄣ傛暀鑲茬▼搴」輗鐨勤樉钁楁樊寮骨紝榪欐槸鍏辮瘑銆傚擭澶栵紝鍦ˋDL銆丟DS銆佸叴瓚ｅ箍娉涘害鏂歸潰錛氧敺鎬殑銆佷綆騫撮緞緇動殑銆佸叴瓚ｅ箍搴﹀鐨澿CAI鍧囧銆傜敳姝彁紺轟漢浠細棰勯槻琛拌觥紝寤剁紦釤村惰闄埆瀹四鐫呸爣澶栵紝鎖晃珮鎖欒偛鍌ㄥ銆佸叴瓚ｅ箍娉蒞佸鎺紺句細錛岸嵇鍙帹榪熸守寤剁紦釤村惰鍙戠敓銆?/p>
杞誨害璁煡鍔熻始鎹熷鐨劇瘖鏂牴鎹甀CD-10璇婃柇鏍囧噯錛氡寶璁板繂銆佸涔豺拰娉ㄦ剩闅滅錛岸父浼撮殢鏅鴻始琛伴錛岸繀闇鏈夌緇忏績鎒奚鏌瘉瀹烇紝甯哥敳濱庤劄鼎劇棶鎴栨崟浼互鍙婂螭鑳藉紩璧峰姛鑳介殰紕嶇殑緋葷粺鼎劇棶鎵鑷達薊6錛?錛屼篃鏈綏鑰呬互MMSE鐨勫緱鍒骨仛涓哄垽鏂交搴「鋨姛鑳芥崟瀹崇殑渚濇嵁銆傛湰鐮旂┐鐨劇瀵烳CI璁煡鍔熻始鎹熷鐨動壒鐐癸紝閱囧彇浠MSE寰楀垎浣庝簬鐫倨枃鍖栫▼搴﹀垎鐣岸鹼紝鍚屾椂涓嶇鍚圖SM-IV釤村惰鐨劇瘖鏂爣鍑嗙殑鍒欑卓瀹氬叾涓篗CI銆傜粨鏋滃發鐜幫細MCI緇蹺芽NA緇勫渜BCAI嫻嬮獙涓紝鎵鏈綏洛瀛晃」鐨動粨鏋滃潎鏈倨樉钁楁樊寮骨紝鍦ㄥ悇騫撮緞緇勫垎孌墊祴楠屼腑錛靡CAI鎵鏈綏崟鍥豺瓙緇撴灉鍧呸湁鏄捐憲鎬樊寮骨紝涓斿渜GDS銆丄DL銆佸叴瓚ｅ箍搴︽柟闈篃涓庢甯哥粍鏈夌潃鏄捐憲鎬樊寮傘傛彁紺猴細MCI鑰喋螭鑳芥槸鏃┼湡鎴栨棭鏃┼湡鐨動輗鍛嗚他紝鎴枻螭鑳芥槸鐙珛鼎劇棶鐨勫崟鍏津紝榪戛湡鐨動爺絀舵樉紺猴細MCI鑰喋發鐢熹輗鍛嗙殑鍗遍櫓鎬瀨楂橈薊7錛?錛屾晟搴斿紩璧烽噸瑙嗭紝鎖愭棭棰勯槻銆?/p>
鏈爺絀舵樉紺猴細鑰佸勾鎴愬紲炵粡蹇冪悊嫻嬮獙錛岸疄鏂界畝渚匡紝鏃豺場浼紝璐圭敤浣庡粔錛岸螭闈豹珮錛屼究濱庢帹騫誇嬌鐢紝瀵池CI鍙婄輗鍛嗙殑棰勤祴銆侀闃叉湁涓瀹氡剩涔齋?/p>
銆愬弬鑰寫枃錏?/strong>
錛?錛? 寮豹梅鍥?紲炵璇勫畾閱忚〃鎵嬪淅錛撰錛?闀挎矙錛氡箹鍗屋瀛︽妧鏈嚭鐗堡錛?998錛?4.
錛?錛? 鑲栦笘瀵岋紝濮氬煿鑺紝寰? 宸圮紝絳? 涓栫卓綺劇鍗敓緇動粐鑰佸勾璁煡鍔熻始璇蹺環鎴愬紲炵粡蹇冪悊嫻嬮獙鐨蹺復搴婂垵姝簲鐢薊J錛?涓崖綺劇縐戛灌蹇楋紝1999錛?2錛?錛多細230.
錛?錛? World Health Organization.World Health Organization-Battery of Cognitive Assessment Instrument for Elderly.Geneva,WHO,1996.
錛?錛? 寮豹梅鍥紝浣疊堤鐜詫紝鏉庢煍鍐幫紝絳?鑰佷漢璁煡鍔熻始鍙樺寲鍙婂叾鎰仁菎錛籎錛?涓浗涓村簥蹇冪悊鏉傚織,1994,2(2):65-68.
錛?錛? Pierre C.Alzheimer's disease?Annals of Medicine.2000,32(1):6-14.
錛?錛? 鑼太笨鍐?奼悜涓?璇?ICD-10綺劇琛屼負闅滅鍒嗙被錛撰錛?鍖箋含錛氫漢姘賊崼鐢熷嚭鐗堡,1993錛?5.
錛?錛? 鏉庢槬娉?寮豹梅鍦?紺懼尯鑰佷漢璁煡鍔熻始鐨勫姩鎬佸彉鍖枻強涓村簥鎰仁菎錛撰錛?涓婃搗綺劇鍖誨,1998,10錛堝鍒娩級:23-26.
