銆愭忐瑕并?/strong> 燧殑锛氩垎鏋愭宁歌佷汉缁?NA),镌变笉钖屾埆銆佸勾榫勤銆佹暀镶茬▼搴﹀垎灞傜殑钥佸勾鎴愬绁炵粡蹇幂悊娴嬮獙锛圔CAI锛夌殑锏圭偣鍙奛A涓庤交搴「锇姛鑳芥崟瀹筹纸MCI锛夎佷汉镄澿CAI镄动壒镣癸绂鎺三储瀵圭輗锻嗙殑棰勤祴鍜屾棭链熻喑鏂殑浠峰笺傛楠娉曪细阅囩敤妯柇闱三爷绌讹纴瀵硅窘瀹侀儴鍒骨湴鍖?0佷互涓匊佷汉杩渎钥佸勾鎴愬蹇幂悊娴嬮獙銆傜粨鏋滐细BCAI瀵规宁歌佷汉銆丮CI镄勫垽瀹氩嗳纭巼楂朴侻CI缁跷芽NA缁跷莿哄碆CAI镓链绥崟锲豺瓙娴嬮獙鎴愮哗链倨樉楁樊寮骨绂姝ｅ父钥佷汉缁勤宁锁栾偛绋嫔害鍒嗙▼銆乄HO锛厦CAI镄勫夬閮ㄥ崟锲豺瓙娴嬮獙鎴愮哗链倨樉楁樊寮伞傜粨璁猴细MCI缁勤湁澶氡楠闱三殑璁煡锷熻始鎹熷锛屾宁歌佷汉缁勤暀镶插偍澶囱秺楂楤CAI鎴愮哗瓒婂銆尽CAI瀵池CI镞┼湡棰勤祴链夎偗瀹氢綔鐢ㄣ?
銆愬剐阌瘝銆?/strong> 钥佸勾鎴愬绁炵粡蹇幂悊娴嬮獙锛泪宁镐汉锛渎交搴「锇姛鑳芥崟瀹?/p>
燧墠鎴贼浗涓庤侀缎燧稿剐哄镞祩鏄庢樉锛屻佸勾钐村惰鍙匊佸勾杞诲害璁煡锷熻始鎹熷钥呰秺鏉秺澶泛纴宸插弹鍒扮浼氧殑楂桦害阅嶈銆傛湰鏂囧钥佸勾滨哄渜鏂囧寲绋嫔害銆佸勾榫勚佹埆鏂归溃锛岸挨鍏舵槸绁炵粡蹇幂悊鍙匊涓虹殑鍙桦寲鏂归溃鏉扫璁ㄨ佸勾滨洪梾棰朴傝揪鍒版棭链熼娴嬶纴寤剁紦钐村惰镄动洰镄勚?/p>
1 瀵硅薄鍜屾楠娉?/strong> 1.1 瀵硅薄 鍙匾瘯钥喋潎涓烘湰宁备袱镓锁侀櫌鍜屻佸共閮ㄥ眬阃浼?0佷互涓婄殑钥佷汉銆傛宁哥粍镄剧佷汉韬綋锅悍锛屾棤涓吨韬綋鼎剧梾锛岸苟涓旇始閰嶅悎娴奶瘯 銆效叆缁勤爣鍑嗭细(1)镙规嵁骞撮缎60~69并?0~79并?0佷互涓婂垎涓轰笁缁彻绂锛?锛倨宁涓夌鍙楁暀镶茬▼搴﹀垎涓烘枃燧层佸曤瀛︼纸锁栾偛骞撮檺≤6骞达级鍙娄腑瀛︽守浠芄锛垄暀镶插勾闄愶帔6骞达级锛涳纸3锛?2渚嬫宁歌佷汉缁动驱濂冲悇36钖圮纴涓夌粍镌倨瘮渚嫔垎閰嶅潎绛斋效纾宁哥粍锛屻交搴「锇姛鑳芥崟瀹宠?2滨恒?/p>
1.2 鏂规碜 阅囩敤宸哄鈶犵亩鏄庢櫤锷兑姘镐佹镆纸MMSE锛变负绛泪煡宸哄锛?锛?锛屾宁鍙楁暀镶茬▼搴︼纸MMSE锛倨诲垎绱锛屾枃燧?ge;18鍒嗭绂灏忏≥20鍒嗭绂涓浠芄≥25鍒嗕负姝ｅ父钥佸勾滨恒效叾瀹林绠滨庡悇椤瑰垎炼艰喋垪涓哄纾宁哥粍銆滀忪镌变芄娴风簿绁炱崼鐢爨腑蹇江夌敤镄剧佸勾鎴愬绁炵粡蹇幂悊娴嬮獙锛圔attery of Cognitive Assessment Instruments锛靡CAI锛变负锘虹锛?锛?锛?杩渎娴嬮獙锛岸唴瀹瑰置鎷纸1锛变竴鑸祫鏂欙绂锛?锛绥惉瑙夎瘝姹囷绂锛?锛绥垎绫伙绂锛?锛倨敞阌娴嬮獙锛涳纸5锛夎绣锷ㄦ祴楠岋绂锛?锛夎瑙夎鲸璁姛鑳斤绂锛?锛夎瘝姹囧欢杩熷洖蹇嗭绂锛?锛夌└哄寸粨鏋彻绂锛?锛夎绰绾跨瓅杩渎璇勫畾銆滀憿鍏朵曲阅忚〃锛氡棩宁哥敓娲昏始锷涢噺琛纸ADL锛多蓟1锛?銆傝瘎瀹氡棩宁哥敓娲荤殑镊悊鑳藉姏锛泪讳綋阃鍖栭噺琛纸GDS锛夎瘎瀹氡讳綋阃鍖栫姘鍐碉蓟1锛?銆滀懀镌囧镓嫔淅锛屾祴楠岸浘锏渊竴濂楋蓟2锛?锛?銆?/p>
2 缁撴灉 棣枻厅瀵?0佷互涓匊佷汉鐢∕MSE绛涢多纴镌绥叆缁勤爣鍑骨垎涓烘宁哥粍锛圢A锛变芽杞诲害璁煡锷熻始缁彻纸MCI锛斋孛A缁彻纴鍙楁暀镶插勾闄愯秺楂椫他纴鍏祃MSE銆丄DL銆丢DS銆佸叴瓒ｅ垎炼煎强BCAI鍒嗛」娴嬮獙鍧回佩锛兑驱濂虫埆涓瑷鑳藉姏锛屻绰绾挎祴楠出驱镐滨庡镐绂镌绥勾榫动粍缁熻涓敞阌娴嬮獙锛屻瘝姹囧洖蹇嗕绠骞撮缎缁勫滨庨佩骞撮缎缁彻纴涓斿潎链夌稗璁〞镒仁菎銆侻CI缁跷芽姝ｅ父缁剧佷汉缁动浉姣旓纴鍏祃MSE銆丄DL銆丢DS銆佸叴瓒ｅ垎炼煎强BCAI娴嬮獙钖勯」鍒骨煎潎鏄庢樉浣庝簬NA钥佷汉锛岸樊寮傛湁鏄捐宪镐傜敳姝湅鏉槥鍙婃暀镶诧纴锁晃佩鍙楁暀镶插勾闄愶纴鑳芥彁楂树汉鍙ｇ礌璐纴钥屼笖鑳藉噺灏戛守鎺ㄨ繜钐村惰镄勫发鐢焜?/p>
2.1 72渚婲A钥佷汉骞撮缎銆佹埆銆佹枃鍖栫▼搴﹀垎宁太琛?銆傝〃1 72渚婲A钥佷汉骞撮缎銆佹埆銆佹枃鍖栫▼搴﹀垎宁?/p>
2.2 NA钥佷汉镄风MSE銆丄DL銆丢DS銆佸叴瓒ｅ箍搴﹀强鍙桦寲瑙佽〃2銆傝〃2 NA钥佷汉镄风MSE銆丄DL銆丢DS銆佸叴瓒ｅ箍搴︽瘮杈写楠宸垎鏋愶纴*锛歅锛?.05锛?*锛歅锛?.01 镌变笉钖屾埆銆佸勾榫勤銆佹暀镶茬▼搴﹀垎灞傜殑MMSE銆丄DL銆丢DS銆佸叴瓒ｅ箍搴﹀垎炼肩粨鏋滃琛?镓绀猴细MMSE銆佸叴瓒ｅ箍搴︽昏祩锷跨驱镐佩滨庡镐纴浣庡勾榫勤楂树簬楂桦勾榫动粍锛岸挨鍏堕殢锁栾偛绉搫镄勫搴︼纴锻垄樉楁芄鍗囱祩锷裤傝欢DL銆丢DS锻堜笅闄嶈祩锷裤?/p>
2.3 姝ｅ父钥佷汉BCAI娴嬮獙鍒嗛」姣旇缉瑙佽〃3銆?/p>
鐢辫〃3鍙煡锛屾宁涓嶅伣镐埆銆佸勾榫勚佸弹锁栾偛绋嫔害鍒骨眣WHO鈭旴CAI钖勫崟锲豺瓙锛岄殢镌鍙楁暀镶茬▼搴︾殑澧为佩钖勫崟锲豺瓙炼煎潎锻垄樉楁芄鍗囥傝屾埆銆佸勾榫动粍涓櫎杩炵嚎銆佽瘝姹渊袱鍗曞洛瀛愭湁鏄捐宪镐锛岸叾浠枻悇鍗曞洛瀛愬憟镐讳綋涓婂崌瓒嫔娍锛屾棤鏄捐宪镐傜敳姝张杩涗竴姝愈鏄峬纴锁晃佩鏂囧寲绱犺川镄勯吨瑕佹?/p>
2.4 姝ｅ父钥佷汉銆佽交搴「锇殰纰岖殑MMSE銆丄DL銆丢DS銆佸叴瓒ｅ箍搴﹀彉鍖栫粨鏋滆琛?銆备粠琛?鍙互鐪嫔嚭MMSE銆丄DL銆丢DS銆佸叴瓒ｅ箍搴︽楠闱袱钥呬莿哄村潎链夐佩搴︾殑鏄捐宪镐樊寮伞效挨鍏祃MSE鍒骨肩殑涓嬮檷锛堥檷浣峬级锛岸螭浣滀负镞┼湡绛涢夎交搴「锇殰纰嶅强钐村惰镄勯佩鍗变汉缇殑镌呸爣锛岸叾浠栦笁鏂归溃涔熸湁杈呬绨浣灭敤銆傝〃3 姝ｅ父钥佷汉BCAI娴嬮獙鍒嗛」姣旇缉琛? 姝ｅ父钥佷汉銆佽交搴「锇殰纰岖殑MMSE銆丄DL銆?GDS銆佸叴瓒ｅ箍搴︽瘮杈写楠宸垎鏋愶细**:P锛?.01銆?/p>
2.5 姝ｅ父钥佷汉锛屻交搴「锇殰纰岖殑BCAI娴嬮獙镄勫崟锲豺瓙鍙桦寲瑙佽〃5銆傝〃5 姝ｅ父钥佷汉銆佽交搴「锇殰纰岖殑BCAI娴嬮獙镄勫崟锲豺瓙鍙桦寲浠庤〃5鍙戠帮锛屾宁哥粍涓险CI缁勫渜BCAI娴嬮獙涓纴鍏ㄩ儴鍗曞洛瀛愮粨鏋滃潎链倨樉楁樊寮伞?/p>
3 璁ㄨ 燧墠链绥剐钥佸勾滨鸿锇姛鑳界殑镰旗┐锛屻秺鏉秺板嗕腑滨庡杞诲害璁煡锷熻始鎹熷鍙婄輗锻嗛佩鍗变汉缇殑棰勤祴鏂归溃锛?锛?锛岸挨鍏惰交搴「锇崟瀹筹纸MCI锛倨槸杩贼嚑骞磋佸勾绮剧鍗敓棰骨烟镄跷竴涓爷绌剁攒镣癸蓟5锛?銆傛湰鏂回夌敤镄剧佸勾鎴愬绁炵粡蹇幂悊娴嬮獙鍙畚MSE绛多纴鏄浗闄呴氧敤镄跷芽锲藉唴澶栨湁鍏崇爷绌跺哄链绥螭姣旀?/p>
链爷绌剁粨鏋滆〃鏄峬纴姝ｅ父钥佷汉镄澿CAI鍦ㄤ笉钖出殑镐埆銆佸勾榫勤銆佹暀镶茬▼搴」輗链夌潃鍖哄埆銆傝槠镐讳綋鍒骨煎憟涓婂崌瓒嫔娍锛屼絾鍦ㄦ埆銆佸勾榫勤锛堣绰绾夸芽璇嶆眹鍗曞洛瀛愶级哄存棤鏄捐宪镐樊寮伞傝伞涓庢湁鍏虫枃铔姤阆划浉镇栵纴链绥緟杩涗竴姝扫璁ㄣ傛暀镶茬▼搴」輗镄勤樉楁樊寮骨纴杩欐槸鍏辫瘑銆效护澶栵纴鍦ˋDL銆丢DS銆佸叴瓒ｅ箍娉涘害鏂归溃锛氧驱镐殑銆佷绠骞撮缎缁动殑銆佸叴瓒ｅ箍搴﹀镄澿CAI鍧囧銆傜敳姝彁绀轰汉浠细棰勯槻琛拌觥纴寤剁紦钐村惰闄埆瀹四镌呸爣澶栵纴锁晃佩锁栾偛鍌ㄥ銆佸叴瓒ｅ箍娉莅佸鎺绀句细锛岸嵇鍙帹杩熸守寤剁紦钐村惰鍙戠敓銆?/p>
杞诲害璁煡锷熻始鎹熷镄剧喑鏂抵鎹甀CD-10璇婃柇镙囧嗳锛氡宝璁板繂銆佸涔豺拰娉ㄦ剩阌灭锛岸父浼撮殢鏅鸿始琛伴锛岸繀闇链夌缁忏绩耨奚镆愈瀹烇纴宁哥敳滨庤札鼎剧梾鎴栨崟浼互鍙婂螭鑳藉紩璧峰姛鑳介殰纰岖殑绯荤稗鼎剧梾镓镊达蓟6锛?锛屼篃链绥钥呬互MMSE镄勫缑鍒骨仛涓哄垽鏂交搴「锇姛鑳芥崟瀹崇殑渚涩嵁銆傛湰镰旗┐镄剧瀵烳CI璁煡锷熻始鎹熷镄动壒镣癸纴阅囧彇浠MSE寰楀垎浣庝簬镌倨枃鍖栫▼搴﹀垎鐣岸碱纴钖屾椂涓岖钖图SM-IV钐村惰镄剧喑鏂爣鍑嗙殑鍒櫕卓瀹氩叾涓篗CI銆傜粨鏋滃发鐜帮细MCI缁跷芽NA缁勫渜BCAI娴嬮獙涓纴镓链绥洛瀛晃」镄动粨鏋滃潎链倨樉楁樊寮骨纴鍦ㄥ悇骞撮缎缁勫垎娈垫祴楠屼腑锛靡CAI镓链绥崟锲豺瓙缁撴灉鍧呸湁鏄捐宪镐樊寮骨纴涓斿渜GDS銆丄DL銆佸叴瓒ｅ箍搴︽楠闱篃涓庢宁哥粍链夌潃鏄捐宪镐樊寮伞傛彁绀猴细MCI钥喋螭鑳芥槸镞┼湡鎴栨棭镞┼湡镄动輗锻呜他纴鎴枻螭鑳芥槸镫珛鼎剧梾镄勫崟鍏津纴杩戛湡镄动爷绌舵樉绀猴细MCI钥喋发鐢熹輗锻嗙殑鍗遍橹镐濑楂桡蓟7锛?锛屾晟搴斿紩璧烽吨瑙嗭纴锁愭棭棰勯槻銆?/p>
链爷绌舵樉绀猴细钥佸勾鎴愬绁炵粡蹇幂悊娴嬮獙锛岸疄鏂界亩渚匡纴镞豺场浼纴璐圭敤浣庡粔锛岸螭闱豹佩锛屼究滨庢帹骞夸娇鐢纴瀵池CI鍙婄輗锻嗙殑棰勤祴銆侀阒叉湁涓瀹氡剩涔斋?/p>
銆愬弬钥写枃铔?/strong>
锛?锛? 寮豹梅锲?绁炵璇勫畾阅忚〃镓嫔淅锛撰锛?哄挎瞰锛氡箹鍗屋瀛︽妧链嚭锏堡锛?998锛?4.
锛?锛? 镶栦笘瀵岋纴濮氩煿鑺纴寰? 宸圮纴绛? 涓栫卓绮剧鍗敓缁动粐钥佸勾璁煡锷熻始璇跷环鎴愬绁炵粡蹇幂悊娴嬮獙镄跷复搴婂垵姝簲鐢蓟J锛?涓崖绮剧绉戛灌蹇楋纴1999锛?2锛?锛多细230.
锛?锛? World Health Organization.World Health Organization-Battery of Cognitive Assessment Instrument for Elderly.Geneva,WHO,1996.
锛?锛? 寮豹梅锲纴浣叠堤鐜诧纴鏉庢煍鍐帮纴绛?钥佷汉璁煡锷熻始鍙桦寲鍙婂叾镒仁菎锛籎锛?涓浗涓村簥蹇幂悊鏉效织,1994,2(2):65-68.
锛?锛? Pierre C.Alzheimer's disease?Annals of Medicine.2000,32(1):6-14.
锛?锛? 锣太笨鍐?姹悜涓?璇?ICD-10绮剧琛屼负阌灭鍒嗙被锛撰锛?鍖笺含锛氢汉姘贼崼鐢熷嚭锏堡,1993锛?5.
锛?锛? 鏉庢槬娉?寮豹梅鍦?绀惧尯钥佷汉璁煡锷熻始镄勫姩镐佸彉鍖枻强涓村簥镒仁菎锛撰锛?涓婃捣绮剧鍖诲,1998,10锛埚鍒娩级:23-26.
