摘要目的:探究尿阿尔茨海默病相关神经丝蛋白（AD7C-NTP）与帕金森病（PD）患者认知功能障碍的相关性。方法:回顾性分析2016年4月至2019年8月山东省威海市中心医院收治的90例PD患者的临床资料。将患者按照蒙特利尔认知评估量表（MoCA）评分分为非认知功能障碍组（46例）和轻度认知功能障碍组（44例），另外选取同期性别、年龄相匹配的健康体检者45例作为对照组。分别检测尿AD7C-NTP，血清同型半胱氨酸（Hcy）、尿酸、C反应蛋白（CRP）等，记录MoCA评分、PD Hoehn-Yahr分级（H-Y分级）、左旋多巴当量和服用时间等。AD7C-NTP与各临床指标的相关性采用Pearson分析，采用Logistic回归分析影响PD患者认知功能障碍的危险因素。结果:轻度认知功能障碍组AD7C-NTP和Hcy明显高于对照组和非认知功能障碍组[（3.3 ± 2.3）μg/L比（1.9 ± 1.6）和（2.1 ± 2.0）μg/L、（13.5 ± 3.4）μmol/L比（9.1 ± 4.5）和（11.0 ± 3.1）μmol/L]，非认知功能障碍组明显高于对照组，差异有统计学意义（ P<0.05）；轻度认知功能障碍组尿酸明显低于对照组和非认知功能障碍组[（286.7 ± 62.9）μmol/L比（338.6 ± 70.4）和（322.9 ± 81.2）μmol/L]，非认知功能障碍组明显低于对照组，差异有统计学意义（ P<0.05）。轻度认知功能障碍组MoCA评分明显低于非认知功能障碍组[（22.9 ± 2.9）分比（27.3 ± 2.4）分]，H-Y分级、左旋多巴当量和服用时间明显高于非认知功能障碍组[（2.7 ± 0.7）级比（2.4 ± 0.6）级、（465.8 ± 132.1）mg/d比（405.8 ± 139.5）mg/d和（46.9 ± 22.1）个月比（35.8 ± 24.4）个月]，差异有统计学意义（ P<0.01或<0.05）。Pearson相关性分析结果显示，AD7C-NTP与尿酸、MoCA评分呈负相关（ r= -0.365和-0.586， P<0.01），与H-Y分级、左旋多巴当量、Hcy、服用时间呈正相关（ r = 0.568、0.434、0.362和0.324， P<0.01）。多因素Logistic回归分析结果显示AD7C-NTP、Hcy和H-Y分级是PD患者发生认知功能障碍的独立危险因素（ P<0.01或<0.05），尿酸是独立保护因素（ P<0.05）。 结论:尿AD7C-NTP在PD认知功能障碍患者中表达升高，尿AD7C-NTP水平与认知功能障碍及疾病严重程度存在相关性，可能是评估PD患者认知功能障碍的有效生物标志物。

abstractsObjective:To explore the correlation between urine Alzheimer disease associated neuronal thread protein (AD7C-NTP) and cognitive dysfunction in patients with Parkinson disease (PD).Methods:The clinical data of 90 patients with PD in Weihai Central Hospital in Shandong Province from April 2016 to August 2019 were retrospectively analyzed. According to the Montreal cognitive assessment scale (MoCA) score, the patients were divided into non cognitive impairment group (46 cases) and mild cognitive impairment group (44 cases). Forty-five healthy persons matched in gender and age were selected as control group. The urine AD7C-NTP, and serum homocysteine (Hcy), uric acid, C-reactive protein (CRP) were detected. The MoCA score, PD Hoehn-Yahr classification (H-Y classification), levodopa equivalent dose and time of taking medicine were record. The correlation between AD7C-NTP and various clinical indicators was analyzed by Pearson method. Risk factors of cognitive dysfunction in patients with PD were analyzed by Logistic regression.Results:The AD7C-NTP and Hcy in mild cognitive impairment group were significantly higher than those in control group and non cognitive impairment group: (3.3 ± 2.3) μg/L vs. (1.9 ± 1.6) and (2.1 ± 2.0) μg/L, (13.5 ± 3.4) μmol/L vs. (9.1 ± 4.5) and (11.0 ± 3.1) μmol/L, the indexes in non cognitive impairment group were significantly higher than those in control group, and there were statistical differences ( P<0.05). The uric acid in mild cognitive impairment group was significantly lower than that in control group and non cognitive dysfunction group: (286.7 ± 62.9) μmol/L vs. (338.6 ± 70.4) and (322.9 ± 81.2) μmol/L, the index in non cognitive impairment group was significantly lower than that in control group, and there were statistical differences ( P<0.05). The MoCA score in mild cognitive impairment group was significantly lower than that in non cognitive impairment group: (22.9 ± 2.9) scores vs. (27.3 ± 2.4) scores, the H-Y classification, levodopa equivalent dose and time of taking medicine were significantly higher than those in non cognitive impairment group: (2.7 ± 0.7) stages vs. (2.4 ± 0.6) stages, (465.8 ± 132.1) mg/d vs. (405.8 ± 139.5) mg/d and (46.9 ± 22.1) months vs. (35.8 ± 24.4) months, and there were statistical differences ( P < 0.01 or<0.05). Pearson correlation analysis result showed that AD7C-NTP was negatively correlated with uric acid and MoCA scores ( r = -0.365 and -0.586, P < 0.01), and positively correlated with H-Y classification, levodopa equivalent, Hcy and time of taking medicine ( r = 0.568, 0.434, 0.362 and 0.324; P < 0.01). Multivariate Logistic regression analysis result showed that AD7C-NTP, Hcy and H-Y classification were independent risk factors of cognitive dysfunction in patients with PD ( P < 0.01 or<0.05), and uric acid was an independent protective factor ( P < 0.05). Conclusions:The expression of urine AD7C-NTP is increased in PD patients with cognitive impairment. The level of urine AD7C-NTP is correlated with cognitive impairment and disease severity, which may be an effective biomarker of cognitive impairment in PD patients.