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摘要：
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目的:探讨联合延迟记忆测验对简易智能状态量表(MMSE)筛查痴呆准确性的影响。方法:对流行病学调查抽取的301人,应用MMSE和延迟记忆测验进行痴呆筛查,痴呆诊断按照美国精神疾病诊断和统计手册第三版修订版(DSM-Ⅲ-R)的标准,比较延迟记忆测验与MMSE单独或联合应用筛查痴呆的效度和信度。结果:以MMSE(文盲≤17分、小学≤20分、初中及以上≤24分为阳性)作为筛查痴呆的指标,其特异性、敏感性、假阳性率、假阴性率分别为85.40%、52.43%、47.56%、14.60%;以物体记忆测验进行延迟记忆测试,得分≤10分作为判断痴呆的指标,其特异性、敏感性、假阳性率、假阴性率分别为74.45%、92.07%、7.93%、25.55%;将MMSE和延迟记忆测试并联筛查痴呆,其特异性、敏感性、假阳性率、假阴性率分别为95.62%、49.39%、50.61%、4.38%;将MMSE和延迟记忆测验串联筛查痴呆,其特异性、敏感性、假阳性率、假阴性率分别为64.23%、95.73%、4.27%、35.77%。结论:MMSE和延迟记忆测验并联可显著提高痴呆筛检的敏感性,降低假阴性率,减少漏诊,适用于痴呆流行病学调查;MMSE和延迟记忆测验串联可显著提高痴呆诊断的特异性,降低假阳性率,减少误诊,对早期诊断痴呆有较大帮助。
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Objective:To study the influence of screening dementia with mini-mental state examination (MMSE) combining with delay memory test. Methods: MMSE and delay memory test are used in screening 301 residents. The diagnosis of dementia is according to the DSM-Ⅲ-R criterion. The validity and reliability were studied when the MMSE and delay memory test were used to screen dementia alone or combined. Results: When MMSE was used to screen dementia alone, the specificity, sensitivity, false positive proportion and false negative proportion were 85.40%, 52.43%, 47.56% and 14.60% respectively. When delay memory test was used to screen dementia alone, the specificity, sensitivity, false positive proportion and false negative proportion were 74.45%, 92.07%, 7.93% and 25.55% respectively. If parallel connection of MMSE and delay memory test were used to screen dementia, the specificity, sensitivity, false positive proportion and false negative proportion were 95.62%, 49.39%, 50.61% and 4.38% respectively. If MMSE was in series with delay memory test, the specificity, sensitivity, false positive proportion and false negative proportion of screening dementia were 64.23%, 95.73%, 4.27% and 35.77% respectively.Conclusion: The parallel connection of MMSE and delay memory test can elevate sensitivity of screening dementia and decrease false negative proportion, so it is important in epidemiologic investigation. MMSE in series with delay memory test will raise specificity of screening dementia and decrease false positive proportion, so it is useful for diagnosing early dementia.
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基金项目：
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CMB基金(项目号:96906)
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作者简介：
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参考文献：
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