血清基质金属蛋白酶-3在类风湿关节炎疾病活动和骨侵蚀中的价值  

The Value of serum matrix metalloproteinase-3 in the disease activity and bone erosion ofRheumatoid Arthritis

作　　者：石亚妹[1] 吴雪 孟新艳[1] 罗采南[1] 雷鑫[1] 陈晓梅[1] 武丽君[1] SHI Ya-mei;WU Xue;MENG Xin-yan;LUO Cai-nan;LEI Xin;Chen Xiao-mei;WU Li-jun(People’s Hospital of the Xinjiang Uygur Autonomous Region,Urumqi,830001,China)

机构地区：[1]新疆维吾尔自治区人民医院,乌鲁木齐830001

出　　处：《新疆医学》2021年第11期1225-1228,共4页Xinjiang Medical Journal

基　　金：国家卫生健康委科教司技术推广扶贫项目(项目编号:2019JSTG09)。

摘　　要：目的探讨血清基质蛋白酶(sMMP)-3在评估类风湿关节炎(RA)病情活动、骨侵蚀中的价值。方法系统性收集在新疆维吾尔自治区人民医院风湿免疫科确诊的200例RA患者的临床及实验室资料,根据28个关节疾病活动指数(DAS28-ESR)分为稳定期(DAS28≤2.6)、低疾病活动度(2.6<DAS28≤3.2)、中疾病活动度(3.2<DAS28≤5.1)、高疾病活动度RA(DAS28>5.1),收集年龄及性别匹配健康体检人群78例,通过酶联免疫吸附方法(ELISA)检测sMMP-3,肌肉骨骼超声判断有无骨侵蚀。结果(1)RA患者sMMP-3的水平38.47(26.40,61.44)ng/mL明显高于健康组5.91(4.47,9.23)ng/m L(P<0.001),高疾病活动度RA患者sMMP-3水平47.29(34.64,84.00)ng/mL高于中疾病活动RA患者42.19(29.30,57.98)ng/mL(P<0.05);中疾病活动度RA患者sMMP-3水平明显高于稳定期和低疾病活动度RA患者18.39(10.68,27.58)ng/mL(P<0.001);(2)sMMP-3水平与DAS28评分(r=0.516,P<0.001)、血沉(r=0.352,P<0.001)、CRP(r=0.357,P<0.001)呈明显正相关;(3)RA患者有骨侵蚀的sMMP-3水平41.88(28.80,74.25)ng/mL高于无骨侵蚀的sMMP-3水平37.18(24.64,53.48)ng/mL(P<0.05),应用Logistic单因素回归分析显示ESR、DAS28、CRP是骨侵蚀的危险因素(P<0.05),而Logistic多因素回归分析显示仅sMMP-3是骨侵蚀的危险因素(P<0.05)。结论sMMP-3可用于评估RA患者病情活动,可能是预测骨侵蚀的危险因素。Objective To investigate the value of serum matrix metalloproteinase-3(s MMP-3)in the assessment ofdisease activityand bone erosion in patients with Rheumatoid Arthritis(RA).Methods The clinical data and laboratory test results among two hundred RA patients were collected from the Department of Rheumatology at People’s Hospital of Xinjiang Uygur Autonomous Region.According to the level of disease activity,all cases weredivided intofour groups,groupwith remission(DAS28≤2.6),groupwith low disease activity(2.6<DAS28≤3.2),group with Medium disease activity(3.2<DAS28≤5.1)and group with high disease activity(DAS28>5.1).78 healthy subjects were recruited as controls.s MMP-3 was detected by ELISA,Bone erosion was detected by musculoskeletal ultrasound method.Results(1)s MMP-3 was significantly higher in RA patientswhich was 38.47(26.40,61.44)ng/m L than that of healthy subjects which was 5.91(4.47,9.23)ng/m L(P<0.001).s MMP-3 was higher in RA patients with High disease activity which was 47.29(34.64,84.00)ng/m L than that in group with medium disease activity which was 2.19(29.30,57.98)ng/m L(P<0.05).s MMP-3 was significantly higher in RA patients with Medium disease activity than that in group with remission and group with Low disease activity which was 18.39(10.68,27.58)ng/m L(P<0.001);(2)The level of s MMP-3 was significantly correlated with DAS28(r=0.516,P<0.001),ESR(r=0.352,P<0.001),CRP(r=0.357,P<0.001);(3)The level of MMP-3 with bone erosion in RA patients was41.88(28.80,74.25)ng/m Lwhich was higher than that without bone erosion which was 37.18(24.64,53.48)ng/m L(P<0.05).Logistic single-factor regression analysis showed that ESR,DAS28 and CRP were risk factors for bone erosion(P<0.05),while Logistic multiplefactor regression analysis showed that only s MMP-3 was risk factor for bone erosion(P<0.05).Conclusions s MMP-3 can be used to evaluate the disease activity in RA patients and may be a risk factor for predicting bone erosion.

关 键 词：类风湿关节炎 血清基质金属蛋白酶3 病情活动 骨侵蚀 

分 类 号：R593[医药卫生—内科学]