MMP-3、GPI和Anti-CCP在类风湿关节炎诊断中的应用  

Application of MMP-3,GPI and anti-CCP in the diagnosis of rheumatoid arthritis

作　　者：常珊碧 王跃帮 沈洁 蒋曼丽 崔倩 裴兵 CHANG Shanbi;WANG Yuebang;SHEN Jie;JIANG Manli;CUI Qian;PEI Bing(Department of Medical Laboratory,Suqian First Hospital,Suqian 223800,Jiangsu,China)

机构地区：[1]宿迁市第一人民医院医学检验科,江苏宿迁223800

出　　处：《西部医学》2024年第11期1687-1691,共5页Medical Journal of West China

基　　金：宿迁市科技项目临床医学检验实验室项目(M201902)。

摘　　要：目的探讨类风湿关节炎(RA)患者基质金属蛋白酶3(MMP-3)、葡萄糖-6-磷酸异构酶(GPI)和抗环瓜氨酸多肽抗体(anti-CCP)等标志物血清中的水平及对RA临床诊断的应用价值。方法选取2022年3月—2022年11月我院风湿免疫科收治的RA患者101例为观察组。另选择同期本院体检健康者96例为对照组。采用酶联免疫吸附试验法(ELISA)分别检测MMP-3、GPI和anti-CCP,采用免疫比浊法检测类风湿因子(RF)、抗链球菌溶血素(ASO)、C反应蛋白(CRP)、补体C3、补体C4,全自动血沉仪法检测血沉(ESR),电化学发光法检测25-羟维生素D 3[25(OH)D 3],比较两组血清中MMP-3、GPI和anti-CCP、RF、ASO、CRP、C3、C4、ESR以及25(OH)D 3水平,绘制受试者工作特征曲线(ROC)曲线分析单项检测和联合检测诊断RA价值。结果观察组血清中MMP-3、GPI、anti-CCP、RF、CRP、C3、C4、ESR明显高于对照组,ASO、25(OH)D 3明显低于对照组(均P<0.05),ROC曲线结果显示MMP-3、GPI、anti-CCP联合检测时的曲线下面积最大为0.997,敏感度97.8%、特异度94.7%,且MMP-3、GPI、anti-CCP是RA的独立危险因素。结论联合检测RA患者血液中MMP-3、GPI和Anti-CCP时,具有较高的诊断效能,能够为RA的诊断提供一定的依据。Objective To analyze the serum levels of matrix metalloproteinase-3(MMP-3),glucose-6-phosphate isomerase(GPI)and anti-cyclic citrulline peptide containing citrulline(anti-CCP)markers in patients with rheumatoid arthritis(RA),and explore their clinical value in the diagnosis of rheumatoid arthritis(RA).Methods 101 patients with rheumatoid arthritis who were treated in the Department of Rheumatology and Immunology of our hospital from March 2022 to November 2022 were selected as the experimental group.96 healthy people were selected as the control group.MMP-3,GPI and anti-CCP were detected by enzyme-linked immunosorbent assay(ELISA),RF,ASO,CRP,C3,C4 were detected by immunoturbidimetry,ESR was detected by automatic ESR,and 25(OH)D 3 was detected by electrochemiluminescence method.The statistical differences between MMP-3,GPI and anti-CCP,RF,ASO,CRP,C3,C4,ESR and 25(OH)D 3 in the serum of the two groups were analyzed,ROC curve to analyze the diagnostic value of single test and combined test for RA.Results The serum levels of MMP-3,GPI,anti-CCP,RF,CRP,C3,C4,ESR in patients with rheumatoid arthritis were significantly higher than those in the control group(P<0.05).The ASO,25(OH)D 3 were significantly lower than those in the control group(P<0.05).The ROC curve showed that the maximum area of MMP-3+GPI+anti-CCP curve was 0.997,the sensitivity was 97.8%,the specificity was 94.7%,and MMP-3,GPI Anti-CCP was an independent risk factor for RA.Conclusion The combined detection of MMP-3,GPI and Anti-CCP has high diagnostic efficacy and can provide evidence for the diagnosis of RA.

关 键 词：类风湿关节炎 基质金属蛋白3 葡萄糖-6-磷酸异构酶 抗环瓜氨酸多肽抗体 

分 类 号：R593.22[医药卫生—内科学]