MoCA是用来检测SLE患者认知障碍的一项简单易用的筛查试验， 它可以作为临床随访中认知改变早期检测的实用工具。

背景

系统性红斑狼疮(SLE)是一种累及多系统的慢性炎症性疾病，同时也可能与包括认知障碍在内的多种神经精神病学表现有关。而基于筛查测试的认知评估可以识别出与SLE相关的早期认知改变。本研究的目的是评估MoCA(蒙特利尔认知评估量表)、MMSE(简易精神状态检查表)、CSI(认知症状量表)这三种筛查试验与神经生理成套试验(金标准)的评估效果的差异，从而找出一个评估SLE患者认知障碍的最有效的筛查试验。

方法

根据2012年系统性红斑狼疮国际联合诊疗(SLICC)标准，这项观察性横断面研究招募了44名患者，他们都于2017年8月至12月期间被诊断为SLE而且没有其他器质性或精神性合并症。分别使用MoCA，MMSE，CSI和金标准评估所有患者，随后进行Spearman相关性和曲线下面积(AUC)分析， P <0.05被认为是差异显著的。

结果

结果显示：与金标准相关性最高的是MoCA试验(AUC=99.4%，P <0.001，敏感性=84%，特异性=100%);其次是MMSE试验(AUC = 92.6%，P <0.001，敏感性=54.8%，特异性=100%)和CSI(AUC = 30.6%，P <0.05，敏感性=54.8%，特异性=30.76%)。

结论

MoCA是用来检测SLE患者认知障碍的一项简单易用的筛查试验， 它可以作为临床随访中认知改变早期检测的实用工具。

原 文

The Montreal Cognitive Assessment Test: A Useful Tool in Screening of CognitiveImpairment in Patients With Systemic Lupus Erythematosus.

Abstract

BACKGROUND/OBJECTIVE:

Systemic lupus erythematosus (SLE)is an inflammatory, chronic, and multisystemic disease, which may be associatedwith a wide range of neuropsychiatric manifestations,including cognitive impairment. Cognitive evaluations based on screening tests might identify early SLE-related cognitivealterations. The aim of this study was to evaluate and to compare the efficacyof three screening tests (Montreal Cognitive Assessment [MoCA], Mini MentalState Examination [MMSE], Cognitive Symptom Inventory [CSI]) against the goldstandard (neuropsychological battery), in order toidentify the most efficient screening test for cognitive impairment in patientswith SLE.

METHODS:

This observational cross-sectionalstudy recruited 44 patients, from August to December 2017, who were diagnosedwith SLE according to the Systemic Lupus International Collaborating Clinics(SLICC) Criteria 2012, and had no medical or psychiatric comorbidities. Thepatients were evaluated using the MoCA, MMSE, CSI, and the gold standard.Spearman's correlation and area under the curve analysis were performed; P <0.05 was considered significant.

RESULTS:

The MoCA test showed the highestcorrespondence with the gold standard (AUC = 99.4%, P < 0.001), sensitivity(84%), and specificity (100%). This was followed by the MMSE (AUC = 92.6%, P< 0.001; sensitivity, 54.8%; specificity, 100%) and the CSI (AUC = 30.6%, P< 0.05; sensitivity, 54.8%; specificity, 30.76%).

CONCLUSION:

TheMoCA is a brief, easily applied screening test that is highly effective fordetecting cognitive impairment in SLE patients. It could be useful in clinicalfollow-up as a tool for early detection of cognitive alterations.This is anopen-access article distributed under the terms of the Creative CommonsAttribution-Non Commercial -No Derivatives License 4.0 (CCBY-NC-ND), where itis permissible to download and share the work provided it is properly cited.The work cannot be changed in any way or used commercially without permissionfrom the journal.