目的 探讨蒙特利尔认知评估量表(montreal cognitive assessment,MoCA)、事件相关电位(event-related brain potentials,ERPs)P300变化对维持性血液透析(maintenance hemodialysis,MHD)患者轻度认知功能损害(mild cognitive impairment,MCI)筛查中的应用.方法 对20例MCI患者和20例健康对照者进行P300检查,应用MoCA评定受试者的知能状态.结果 MoCA中除命名及定向力评分无统计学意义外(t=-1.180,P=0.246;t=-0.380,P=0.700),其它亚项评分在MCI组和对照组间差异均有统计学意义(P＜0.05)；与正常组相比,MHD患者P300潜伏期延长(367.25±34.14比304.30±18.82)、波幅降低(7.85±2.56比11.14±2.15),差异有统计学意义(t值分别为7.22,-4.40,P均＜0.01); MCI组P300潜伏期延长,与MoCA总分及亚项中视空间与执行功能、注意力、延迟回忆成负相关,相关系数分别为-0.942、-0.831、-0.802、-0.856(P＜0.01)；其波幅下降与之成正相关,相关系数分别为0.830、0.896、0.864、0.881(P＜0.01). 结论 P300、MoCA检测对MHD患者认知功能障评估较为全面,有助于发现亚临床损害.%Objective To assess the value of the Montreal cognitive assessment (MoCA) and the event-related brain potential P300 in screening mild cognitive impairment (MCI) in maintenance hemodialysis (MHD) patients. Methods Twenty MHD patients and 20 healthy controls were examined for P300 and cognitive performance by the Chinese version of MoCA. Results MHD patients with MCI had significantly lower scores than the healthy subjects in all MoCA sub-Hems except for name (t= -1.18, P =0.246) and fixed orientation sub-items (t= -0.380, P=0.700). The latency of P300 was significantly longer, and the amplitude of P300 was significantly lower in MHD patients than in normal subjects (P < 0.01). The latency of P300 was negatively correlated to the sub-item scores of visual spatial and executive function, attention and delayed recall, and the total MoCA score (P < 0.01). The amplitude of P300 was positively correlated to the sub-item scores of visual spatial and executive function, attention and delayed recall, and the total MoCA score (P < 0.01). Conclusion P300 and MoCA can comprehensively assess MCI in MHD patients, and can help identify sub-clinical cognition damage.
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