2025 年第 9 期 第 20 卷

外周血神经生长因子前体及GATA结合蛋白3与帕金森病患者病情程度和认知功能的相关性研究

Correlation of pro-nerve growth factor and GATA binding protein 3 in peripheral blood with severity and cognitive function in patients with Parkinson′s disease

作者：许媛媛1夏虹1刘卫国2刘佳佳1丁晨琛1

英文作者：Xu Yuanyuan1 Xia Hong1 Liu Weiguo2 Liu Jiajia1 Ding Chenchen1

单位：1南京医科大学第四附属医院神经内科，南京210031；2南京脑科医院神经内科，南京210029

英文单位：1Department of Neurology the Fourth Affiliated Hospital of Nanjing Medical University Nanjing 210031 China; 2Department of Neurology Nanjing Brain Hospital Nanjing 210029 China

关键词：帕金森病；神经生长因子前体；GATA结合蛋白3；认知功能

英文关键词：Parkinson′sdisease;Pro-nervegrowthfactor;GATAbindingprotein3;Cognitivefunction

• 摘要：

• 目的 探讨外周血神经生长因子前体（proNGF）、GATA结合蛋白3（GATA3）与帕金森病患者病情程度和认知功能的相关性。方法 回顾性选取2020年1月至2023年3月南京医科大学第四附属医院收治帕金森病患者158例（PD组）和近期来院健康体检志愿者80例（对照组）。帕金森病患者根据病情程度分为早期组（Hoehn-Yahr分级1～2.5级，32例）、中期组（Hoehn-Yahr分级3级，76例）、晚期组（Hoehn-Yahr分级4～5级，50例），根据认知功能分为帕金森病痴呆（PDD）组［帕金森病认知功能评定量表（PD-CRS）评分≤73分，37例］、帕金森病轻度认知障碍（PD-MCI）组（PD-CRS评分74～80分，68例）、认知正常组（PD-CRS评分＞80分，53例）。检测外周血proNGF、GATA3水平；分析帕金森病患者外周血proNGF、GATA3水平与Hoehn-Yahr分级的相关性。采用非条件有序多分类Logistic回归分析外周血proNGF、GATA3水平与帕金森病患者认知障碍发生发展的关系，受试者工作特征曲线分析外周血proNGF、GATA3水平对其的预测效能。结果 PD组外周血proNGF水平高于对照组，GATA3水平低于对照组（均P＜0.001）。晚期组、中期组、早期组外周血proNGF水平呈降低趋势，GATA3水平呈升高趋势（均P＜0.001）。帕金森病患者Hoehn-Yahr分级与外周血proNGF水平呈正相关（r＝0.775，P＜0.001），与GATA3水平呈负相关（r＝-0.780，P＜0.001）。proNGF为帕金森病患者认知障碍的独立危险因素，GATA3为独立保护因素（均P＜0.001）。外周血proNGF、GATA3水平联合评估帕金森病患者认知障碍和PDD的曲线下面积为0.873、0.868，大于外周血proNGF、GATA3单独评估（均P＜0.05）。结论 帕金森病患者外周血proNGF水平升高和GATA3水平降低，与病情程度加重和认知障碍密切相关，外周血proNGF、GATA3水平联合评估帕金森病患者认知障碍和PDD的能效较高。

• Objective To investigate the correlation of peripheral blood pro-nerve growth factor (proNGF) and GATA binding protein 3 (GATA3) with severity and cognitive function in patients with Parkinson′s disease (PD). Methods A total of 158 patients with PD (PD group) admitted to the Fourth Affiliated Hospital of Nanjing Medical University from January 2020 to March 2023 and 80 healthy volunteers (control group) who had recently visited the hospital for physical examination were retrospectively selected. PD patients were divided into early stage group (Hoehn-Yahr stage 1 to 2.5, 32 cases), middle stage group (Hoehn-Yahr stage 3, 76 cases) and late stage group (Hoehn-Yahr stage 4 to 5, 50 cases) according to the severity of the disease. According to their cognitive function, they were divided into PD dementia (PDD) group ［PD cognitive rating scale (PD-CRS) score≤73, 37 cases］, PD mild cognitive impairment (PD-MCI) group (PD-CRS score 74 to 80, 68 cases) and normal cognitive group (PD-CRS score＞80, 53 cases). The levels of proNGF and GATA3 in peripheral blood were detected. The correlation between proNGF and GATA3 levels in peripheral blood of patients with PD and Hoehn-Yahr stage was analyzed. Unconditional ordinal multinomial Logistic regression was used to analyze the relationship between peripheral blood proNGF and GATA3 levels and the development of cognitive impairment in PD patients. The receiver operating characteristic curve was used to analyze the predictive efficiency of peripheral blood proNGF and GATA3 levels on cognitive impairment. Results The level of proNGF in PD group was higher than that in control group, and the the level of GATA3 was lower than that in control group (both P＜0.001). The level of proNGF in the late stage group, the middle stage group and the early stage group showed a downward trend, and the level of GATA3 showed an upward trend (all P<0.001). The Hoehn-Yahr scale was positively correlated with the level of proNGF (r=0.775, P<0.001) and negatively correlated with the level of GATA3 (r=-0.780, P<0.001) in PD patients. proNGF was an independent risk factor for cognitive impairment in PD patients, and GATA3 was an independent protective factor (all P<0.001). The area under the curve of peripheral blood proNGF and GATA3 levels combined to evaluate cognitive impairment and PDD in PD patients was 0.873 and 0.868, which was larger than those of peripheral blood proNGF and GATA3 levels alone (both P<0.05). Conclusions Elevated levels of proNGF and decreased levels of GATA3 in peripheral blood of PD patients are closely related to disease severity and cognitive impairment. The combination of proNGF and GATA3 levels in peripheral blood has a high energy efficiency in evaluating cognitive impairment and PDD in PD patients.