MMP-3在血清学阴性类风湿关节炎中的诊断价值  

Clinical evaluation of serum MMP-3 in seronegative rheumatoid arthritis

作　　者：韩振格 周琪 韩海荣 陈觅蜜 何东仪 HAN Zhenge;ZHOU Qi;HAN Hairong;CHEN Nimi;HE Dongyi(Department of Clinical Laboratory,Guanghua Hospital of Traditional and Western Medicine,Shanghai 200052,China;Department of Rehabilitation Medicine,the Central Hospital of Xuhui,Shanghai 200031,China;Institute of arthrosis,Guanghua Hospital of Traditional and Western Medicine,Shanghai 200052,China)

机构地区：[1]上海市光华中西医结合医院检验科,上海200052 [2]上海市徐汇区中心医院康复医学科,上海200031 [3]上海市光华中西医结合医院关节病研究所,上海200052

出　　处：《检验医学与临床》2022年第S01期4-7,共4页Laboratory Medicine and Clinic

基　　金：上海市卫生健康委员会资助项目(201640303)。

摘　　要：目的本研究旨在验证MMP-3在血清学阴性风湿性关节炎(RA)诊断中的应用价值。方法选取2017年至2018年上海市光华中西医结合医院628例已确诊RA住院患者,其中阳性RA组患者531例和阴性组RA患者97例及健康对照组321例。检测所有参与者的血清MMP-3、IgM-RF、IgG-RF、IgA-RF和抗-CCP,同时收集患者临床资料。结果阴性组RA患者年龄较大,畸形关节数较少,DAS28评分较低,但与阳性RA组相比差异均无统计学意义(P>0.05)。MMP-3在阴性RA组检出率为44.3%,与其余单项检测方法相比,MMP-3诊断RA的灵敏度最高(64.5%),抗-CCP的特异性最高(99.1%)。IgA、IgG与IgM-RF分型联合检测与单独IgM-RF检测相比,并没提高RA诊断准确性。MMP-3联合抗-CCP与IgA、IgG、IgM-RF分型诊断RA的准确性最高(89.8%)。结论MMP-3与常规诊断方法相比,具有较高的灵敏度和特异性,可以用于临床。Objective The purpose of this study was to verify the value of MMP-3 in the diagnosis of seronegative rheumatoid arthritis(RA).Methods A total of 628 inpatients with RA from 2017 to 2018 were selected.Among them,there were 531 patients as seropositive RA group and 97 patients as seronegative RA group,and 321 healthy checks were selected as a control group.All participants were examined serum MMP-3,IgM-RF,IgG-RF,IgA-RF and anti-CCP,and clinical data were also be collected at the same time.Results The patients with seronegative RA might be older,fewer abnormal joints and lower DAS28 score,but there was no significant difference between the seropositive RA group and the seropositive RA group(P>0.05).The positive rate of MMP-3 was 44.3%in serological negative RA group.Compared with other single detection methods,MMP-3 had the highest sensitivity in the diagnosis of RA(64.5%),and the specificity of anti-CCP was the highest(99.1%).However,the combined detection of IgA,IgG and IgM-RF did not improve the accuracy of RA diagnosis compared to IgM-RF alone.The accuracy of MMP-3 combined anti-CCP,IgA-RF,IgG-RF and IgM-RF was the highest(88.8%).Conclusion Compared to routine diagnosis methods,MMP-3 had a higher sensitivity and specificity,which could be used in clinical practice.

关 键 词：MMP-3 类风湿关节炎 血清学阴性 血清学阳性 

分 类 号：R59[医药卫生—内科学]