【摘要】 目的 探讨蒙特利尔认知评估量表(montreal cognitive assessment，MoCA)在维持性血液透析患者轻度认知功能障碍(mild cognitive impairment，MCI)患者筛查中的应用。 方法 应用简易精神状态检查量表(mini-mental state examination MMSE)、MoCA对20例MCI患者和20例健康对照者进行神经心理评估，比较2者筛查MCI的效果。 结果 MoCA筛查MCI的敏感性为90%、特异性为75% ，MMSE筛查MCI的敏感性为30%、特异性为95% ；MoCA 中除命名及定向力评分无统计学意义(t=-1.18,p=0.246;t=-0.38,P=0.70)外，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)；MMSE中只有计算及延迟回忆2个亚项在MCI组和对照组间差异有统计学意义(t=-4.91, P=0.00;t=-3.87,P=0.00)，其余各项差异均无统计学意义(P＞0.05)。 结论 MoCA为高敏感性的维持性血液透析患者MCI筛查工具，能全面评估MCI患者的认知功能，优于 MMSE量表，值得临床推广使用。

【Abstract】Objective To assess the value of Montreal Cognitive Assessment (MoCA) in screening mild cognitive impairment (MCI) in hemodialysis patients. Methods Twenty hemodialysis patients with MCI and 20 healthy subjects were examined with neuropsychological tests using Mini-mental State Examination (MMSE) and MoCA.  Results The MoCA had a sensitivity of 90% and specificity of 75% for detecting MCI, and the sensitivity and specificity of MMSE were 30% and 95%, respectively. For the MoCA sub-items, hemodialysis patients with MCI had significantly lower scores than the healthy subjects in all cognitive function measures except for name and fixed orientation sub-items (t=-1.18, p=0.246; t=-0.38, p=0.70). In MMSE sub-items, significant differences were found between the two groups in only calculation and delayed recall (t=-4.91, P=0.00; t=-3.87, P=0.00). Conclusions The MoCA is a highly sensitive scale for screening MCI in patients with hemodialysis, which allows comprehensive assessment of patients’ cognitive functions better than the MMSE scale, and thus is worthy of clinical use.