目的:探讨中文版快速认知筛查(Rapid Cognitive Screening,RcS)在中国急性期卒中患者认知障碍筛查中的有效性和可靠性。

方法:对英文版 RCS 量表进行翻译并汉化为中文版本,招募 2020年1月-2020 年6月就诊于常州市第一人民医院急诊科病程在1周以内的的 42 例脑卒中患者,使用简易精神状态检查量表(Mini-mental State Examination,MMSE)量表、蒙特利尔认知评估量表(MontreaCognitive Assessment,MoCA)和中文版 RCS 分别评估其认知功能,系统评价中文版 RCS量表在急性脑卒中患者中的应用价值。

结果:中文版 RCS 量表重测可靠性高度相关[总分组内相关系数(intraclass correlationcoefficient,ICC)为 0.955],评估者间一致性高度相关(ICC为 0.983~0.992)。中文版 RCS 与MMSE 呈中度相关(r= 0.583,P<0.01),与 MoCA 中度相关(r= 0.721,P<0.01),但其与MoCA 的相关性高于 MMSE。受试者操作特征(receiver operating characteristic,ROC)曲线分析结果显示,以 MMSE 为金标准,中文版 RCS 和 MoCA 的曲线下面积(area under curve,AUC)分别为 0.757 和 0.824,RCS 截断值为 5.5 分时,识别认知障碍的敏感度和特异度分别为 0.789 和 0.609:以 MoCA 为金标准,RCS和 MMSE 的 AUC 分别为 0.929 和 0.894,RCS的截断值为 8.5 分时,识别认知障碍的敏感度和特异度分别为 0.714 和 0.913。

结论:中文版 RCS 是一种简单、快速且有效的认知功能筛查工具,具有良好的有效性和可靠性,可以作为急性脑卒中患者认知功能的快速筛查工具。

Objective: To explore the effectiveness and reliability of the Chinese version of Rapid Cognitive Screening (RCS) in the detection of cognitive impairment in acute stroke patients from China.

Methods: The original version of RCS was translated into Chinese version, and we recruited 42 acute stroke patients within one week of the disease course who were admitted to emergency department of First People's Hospital of Changzhou from January 2020 to May 2020.All participants were evaluated by Mini-Mental State Examination(MMSE), Montreal Cognitive Assessment (MoCA) and Chinese version of RCS respectively,and then we analyzed the clinical application value of the Chinese version of RCS inpatients with acute stroke systematically.

Results: The Chinese version of RCS was highly correlated with retest reliability [the in traclass correlation coefficient (ICC)=0.955], and it had high correlation of consistency between evaluators (ICC=0.983-0.992). The Chinese version of RCS was moderately correlated with MMSE (r=0.583, P<0.01) and MoCA (r=0.721,P<0.01), but its correlation with MoCA was higher than that of MMSE. Receiver operating characteristic (ROC) curve analyses showed that the area under the curve (AUC) of RCS and MoCA are 0.757 and 0.824 with MMSE as the gold standard, when cut off value was 5.5,the sensitivity and specificity for identifying cognitive impairment were 0.789 and 0.609, respectively.The AUC of RcS and MMSE were 0.929 and 0.894 with MoCA as the gold standard, when cut off value was 8.5 the sensitivity and specificity for identifying cognitive impairment were 0.714 and 0.913 respectively.

Conclusion:In the cognitive assessment of patients with acute stroke, the Chinese version of RCS is a simple, fast,and effective cognitive function screening tool with good effectiveness and reliability, and can be used as a rapid screening tool for cognitive function in patients with acute stroke.