血清MMP9、ADAM10联合对类风湿关节炎患者颈动脉粥样硬化的诊断价值  

The Diagnostic Value of Serum MMP9 Combined ADAM10 in Patientswith Rheumatoid Arthritis with Carotid Atherosclerosis

作　　者：李洪峰 李敏[1] 吴亚[2] 焦永伟[3] 苏军华[4] LI Hongfeng;LI Min;WU Ya;JIAO Yongwei;SU Junhua(Department of Orthopedics,General Hospital of Jizhong Energy Fengfeng Group Co.Ltd.Shijiazhuang 056200,China;Department of Clinical Laboratory,Hospital of Traditional Chinese Medicine,Shijiazhuang 050000,China;Department of Orthopedics,Hospital of Traditional Chinese Medicine,Shijiazhuang,050000,China;Department of Clinical Laboratory,The Second Hospital of Hebei Medical University,Shijiazhuang 050000,China)

机构地区：[1]冀中能源峰峰集团有限公司总医院骨科,河北石家庄056200 [2]河北省中医院检验科,河北石家庄050000 [3]河北省中医院骨科,河北石家庄050000 [4]河北医科大学第二医院检验科,河北石家庄050000

出　　处：《标记免疫分析与临床》2023年第8期1393-1397,1430,共6页Labeled Immunoassays and Clinical Medicine

摘　　要：目的 探究血清基质金属蛋白酶9(MMP9)、解整合素金属蛋白酶10(ADAM10)联合检测对类风湿关节炎(RA)患者颈动脉粥样硬化(CAS)的诊断价值。方法 纳入2021年2月至2022年7月在我院就诊治疗的89例RA患者为研究对象,将RA患者分为合并CAS组(RA-CAS组)和非CAS组(RA-nonCAS组),同期选择50例在我院进行体检健康者为对照组。使用酶联免疫吸附法(ELISA)测定血清MMP9、ADAM10水平;Pearson相关性分析患者血清MMP9、ADAM10水平与颈动脉内膜中层厚度(IMT)之间的关系;受试者工作特征曲线(ROC)评估MMP9、ADAM10对RA患者并发CAS的诊断价值;Logistic回归分析RA患者发生CAS的影响因素。结果 3组研究对象在性别、年龄、吸烟史、BMI、TC、TG、HDL、LDL上差异无统计学意义(P>0.05);RA-CAS组和RA-nonCAS组在病程上差异有统计学意义,RA-CAS组患者病程显著长于RA-nonCAS组(P<0.05);与对照组相比,RA-CAS组和RA-nonCAS组IMT值、血清MMP9、ADAM10水平均显著升高(P<0.05),且RA-CAS组显著高于RA-nonCAS组(P<0.05);Pearson相关性分析结果显示,RA患者并发CAS血清MMP9、ADAM10水平与IMT值均呈显著正相关(r1=0.568,r2=0.571,P<0.05);ROC曲线显示,MMP9、ADAM10单独诊断RA患者并发CAS的AUC分别为0.879、0.865,灵敏度分别为83.3%、77.1%,特异性分别为66.8%、63.9%,两者联合诊断RA患者并发CAS的AUC为0.963,灵敏度、特异性分别为95.8%、87.0%;多因素Logistic回归分析表明,MMP9、ADAM10是影响RA患者并发CAS的危险因素(P<0.05)。结论 RA并发CAS患者血清MMP9、ADAM10水平显著升高,血清MMP9、ADAM10水平与IMT呈正相关,并且血清MMP9、ADAM10可作为诊断RA患者并发CAS的血清标志物。Objective To explore the diagnostic value of combined detection of serum matrix metalloproteinase 9(MMP9)and a disintegrin and metalloprotease 10(ADAM10)for carotid atherosclerosis(CAS)in patients with rheumatoid arthritis(RA).Methods Eighty-nine RA patients who were treated in our hospital from February,2021 to July,2022 were included in the study.All RA patients were grouped into CAS group(RA-CAS group)and non-CAS group(RA-nonCAS group),while 50 healthy people who had physical examination in our hospital were regarded as the control group.Serum levels of MMP9 and ADAM10 were measured by enzyme-linked immunosorbent assay(ELISA);Pearson correlation was applied to analyze the relationship between serum MMP9,ADAM10 levels and carotid intima-media thickness(IMT);Receiver operating characteristic curve(ROC)was drawn to evaluate the diagnostic value of MMP9 and ADAM10 in RA patients complicated with CAS;Logistic regression analysis was applied to analyze the influencing factors of CAS in RA patients.Results There were no significant differences in gender,age,smoking history,BMI,TC,TG,HDL and LDL among the three groups(P>0.05);There was significant difference in the course of disease between RA-CAS group and RA-nonCAS group,the course of disease in RA-CAS group was significantly higher than that in RA-nonCAS group(P<0.05);Compared with the control group,IMT value,serum MMP9 and ADAM10 levels in RA-CAS group and RA-nonCAS group were significantly higher(P<0.05),while RA-CAS group were significantly higher than RA-nonCAS group(P<0.05);Pearson correlation analysis showed that levels of MMP9 and ADAM10 in RA patients with CAS were significantly positively correlated with IMT(r 1=0.568,r 2=0.571,P<0.05);ROC curve showed that AUCs of MMP9 and ADAM10 alone in diagnosing RA patients complicated with CAS were 0.879 and 0.865,respectively,with the sensitivity of 83.3%and 77.1%,and the specificity of 66.8%and 63.9%,respectively.AUC of combined diagnosis of RA patients with CAS was 0.963,with the sensitivity and specificity of 95.

关 键 词：类风湿关节炎 基质金属蛋白酶9 解整合素金属蛋白酶10 颈动脉粥样硬化 诊断价值 

分 类 号：R593.22[医药卫生—内科学]