关键词: 卒中, 认知障碍, MMSE, MoCA, meta分析

Abstract: Objective: To systematic assess the test value of mini-mental state examination(MMSE) and Montreal cognitive assessment (MoCA) in the diagnosis of post stroke cognitive impairment(PSCI).Methods: An extensive search for related literature from the Wanfang data, CNKI, PubMed, Embase and the Cochrane library up to October 2017 was performed. The articles were included according to the inclusion criteria.The quality of the studies was assessed using the QUADAS-2.Heterogeneity, pooled sensitivity, pooled specificity, pooled positive likelihood ratio(PLR), pooled negative likelihood ratio (NLR), pooled diagnostic odds ratio(DOR) were analyzed by Metadisc 1.4, the area under curve(AUC) of pooled SROC was obtained. The diagnostic accuracy between MMSE and MoCA were compared. Results: 12 studies, including a total of 1072 patients. For MMSE, the studies showed that the pooled DOR was 8.27 [95% confidence interval（95%CI =4.11～16.64）, the pooled sensitivity was 68.9%(95%CI = 63.9%～72.1%), the pooled specificity was 73.4%（95%CI＝71.6%～79.0%）, the pooled PLR was 2.68（95%CI＝1.86～3.85）, the pooled NLR was 0.41（95%CI＝0.27～0.62), and the pooled AUC was 0.806. For MoCA, the studies showed that the pooled DOR was 14.05（95%CI＝9.07～21.78）. The pooled sensitivity was 78.4%（95%CI＝73.7%～82.7%）, the pooled specificity was 73.7%（95%CI＝68.5%～78.4%）, the pooled PLR was 4.14（95%CI＝2.26～7.61）, the pooled NLR was 0.29（95%CI＝0.19～0.41）, and the pooled AUC was 0.868. The RDOR value of the two scales was 1.70（P= 0.14）. Conclusion: The sensitivity and specificity of MoCA were higher than MMSE, the overall diagnostic accuracy of these two scales were both relatively high.Users should choice MoCA or both in different situation.

Key words: Stroke； Cognitive impairment, Mini-mental state examination(MMSE)；Montreal cognitive assessment (MoCA), Meta-analysis