目的：探讨轻度认知功能障碍（mild cognitive impairment，MCI）患者基线认知功能评分和嗅觉评分在痴呆转化中的预测价值。

方法：研究对象为2011 年3 月—2012 年9 月在上海交通大学医学院附属仁济医院神经内科记忆障碍门诊初次就诊的符合病例选择标准的57 例MCI 患者，对其进行认知功能相关神经心理测验[ 简易智力状态检查（Mini-mental State Examination，MMSE）量表、工具性日常生活能力（Instrumental Activity of Daily Living，IADL）量表、蒙特利尔认知评估（Montreal Cognitive Assessment，MoCA）量表、神经精神科问卷（Neuropsychiatric Inventory，NPI）] 以及12 项跨文化嗅觉鉴定试验（12-item Cross-Cultural Smell Identification Test，CC-SIT），并前瞻性随访2 年，定期进行神经心理测验和嗅觉评估。2 年内转化为痴呆的MCI 患者归入MCI 转化组，未转化为痴呆的患者归入MCI 稳定组。应用logistic 回归分析2 年内MCI 转化为痴呆的独立预测因素。

结果：MCI 转化组与MCI 稳定组的基线年龄、性别、教育年限、体质量指数均无显著差异（P ＞ 0.05）；MCI 转化组基线MMSE 量表评分、MoCA 量表评分、IADL 量表评分和嗅觉评分均低于MCI 稳定组，差异有统计学意义（P ＜ 0.001），NPI 评分也低于MCI稳定组，但差异无统计学意义（P ＝ 0.364）。随访2 年，57 例MCI 患者中有18 例转化为痴呆患者，转化率为31.6%。MCI 转化组随访第2 年的MMSE 量表评分、MoCA 量表评分、IADL 量表评分和嗅觉评分仍低于MCI 稳定组，差异有统计学意义（P ＜ 0.001）。logistic 回归分析显示，年龄、体质量指数、教育年限、MMSE 量表评分、IADL 量表评分、MoCA 量表评分、NPI 评分、嗅觉评分均不是MCI 转化为痴呆的独立预测因素（P ＞ 0.05）。

结论：MCI 患者的神经心理测验和嗅觉评估结果可能是MCI 转化为痴呆的潜在预测因素，但仍有待扩大样本量进一步验证。

Objective: To explore the predictive value of baseline cognitive score and olfactory function in conversion from mild cognitive impairment (MCI) to dementia.

Methods: The subjects were 57 patients initially diagnosed of MCI in Memory Disorder Outpatient Department affiliated to the Department of Neurology, Renji Hospital, Shanghai Jiao Tong University School of Medicine from March 2011 to September 2012. The cognitive function-related neuropsychological tests including Mini-mental State Examination (MMSE), Instrumental Activity of Daily Living (IADL), Montreal cognitive assessment (MoCA), Neuropsychiatric Inventory (NPI) and 12-item Cross-Cultural Smell Identification Test were used. Prospective follow-up was performed for 2 years. During 2 years, the regular neuropsychological tests and olfactory assessment were conducted. Within 2 years, MCI patients who converted to dementia were classified into MCI conversion group, and those who did not convert to dementia were classified into MCI stable group. Logistic regression analysis was used to analyze the independent predictors of conversion of MCI to dementia within 2 years.

Results: There were no significant differences in baseline age, sex, years of education and body mass index (BMI) between the MCI transformation group and the MCI stable group (P > 0.05). The baseline MMSE score, MoCA score, IADL score and olfactory score in the MCI conversion group were all lower than those of the MCI stable group, and the difference was statistically significant (P < 0.001); the NPI score was also lower than that of the MCI stable group, but the difference was not statistically significant (P = 0.364). During the follow-up period of 2 years, 18 of the 57 MCI patients were converted to dementia, and the
conversion rate was 31.6%. The MMSE score, MoCA score, IADL score and olfactory score of the MCI group were still lower than those of the MCI stable group in the second year of follow-up, and the difference was statistically significant (P < 0.001). Logistic regression analysis showed that age, BMI, years of education, MMSE score, IADL score, MoCA score, NPI score, and olfactory score were not independent predictors of conversion from MCI to dementia (P > 0.05).

Conclusion: Neuropsychological tests and olfactory assessment may be potential predictors of conversion from MCI to dementia in patients with MCI, but it is still necessary to expand the sample size for further validation.