血清MMP-3、TIMP-1水平及SPARCC评分在活动期中轴型脊柱关节炎病情评估中的意义  

Significance of serum MMP-3,TIMP-1 levels and SPARCC score in evaluating the condition of active axial spinal arthritis

作　　者：刘博[1] 黄志坚[1] 米存东[1] LIU Bo;HUANG Zhijian;MI Cundong(Department of Rheumatology and Immunology,the Second Affiliated Hospital of Guangxi Medical University,Guangxi,Nanning 530007,China)

机构地区：[1]广西医科大学第二附属医院风湿免疫科,广西南宁530007

出　　处：《中国医药科学》2025年第3期82-85,共4页China Medicine And Pharmacy

基　　金：广西医科大学第二附属医院院级科研项目(EFYKY2020019)。

摘　　要：目的 分析血清基质金属蛋白酶-3(MMP-3)、基质金属蛋白酶抑制剂-1(TIMP-1)水平及加拿大脊柱关节炎研究协会骶髂关节炎症(SPARCC)评分在活动期中轴型脊柱关节炎(axSpA)疾病活动度评估中的意义。方法 按标准入组2020年4月至2022年4月就诊于广西医科大学第二附属医院风湿免疫科门诊及住院的axSpA患者35例,予重组人Ⅱ型肿瘤坏死因子受体-抗体融合蛋白、沙利度胺、柳氮磺吡啶治疗12周。用酶联免疫吸附法检测治疗前后血清MMP-3、TIMP-1水平及SPARCC评分,分析三者与基于CRP计算的强直性脊柱炎疾病活动评分(ASDAS-CRP)、强直性脊柱炎疾病活动指数(BASDAI)及红细胞沉降率(ESR)、C反应蛋白(CRP)的相关性;并用受试者工作特征曲线(ROC)评估三者治疗前后差值对治疗产生应答的效能。结果 治疗后血清MMP-3水平、SPARCC评分相比治疗前显著下降,血清TIMP-1水平显著上升(P <0.05)。治疗前血清MMP-3水平与BASDAI、ESR、CRP呈正相关,血清TIMP-1水平与CRP呈负相关,SPARCC评分与BASDAI、CRP呈正相关(P <0.05);治疗后,上述各指标之间未见相关性。MMP-3、TIMP-1、SPARCC差值的ROC曲线下面积分别为0.773、0.667、0.770。结论 血清MMP-3、TIMP-1水平及SPARCC评分对axSpA病情活动、治疗应答情况的评估有较高价值。Objective To analyze the significance of serum matrix metalloproteinase-3(MMP-3),tissue inhibitor of metalloproteinase-1(TIMP-1)levels and Spondyloarthritis Research Consortium of Canada(SPARCC)score in evaluating the condition of active axial spondyloarthritis(axSpA).Methods According to the standard,a total of 35 patients with axSpA admitted to and hospitalized in the Department of Rheumatology Immunology of the Second Affiliated Hospital of Guangxi Medical University from April 2020 to April 2022 were treated with recombinant human tumor necrosis factor-αreceptorⅡ-IgG Fc antibody fusion protein,thalidomide and sulfasalazine for 12 weeks.Serum MMP-3,TIMP-1 levels and SPARCC scores were detected by enzyme-linked immunosorbent assay before and after treatment,and their correlation with ankylosing spondylitis disease activity score-CRP(ASDAS-CRP),bath ankylosing spondylitis disease activity index(BASDAI),erythrocyte sedimentation rate(ESR)and C-reactive protein(CRP)calculated based on CRP was analyzed.Receiver operating characteristic curve(ROC)was used to evaluate the efficacy of the difference before and after treatment.Results After treatment,the serum MMP-3 level and SPARCC score decreased significantly than those at baseline,while the serum TIMP-1 level increased significantly(P<0.05).Before treatment,serum MMP-3 level was positively correlated with BASDAI,ESR and CRP,serum TIMP-1 level was negatively correlated with CRP,and SPARCC score was positively correlated with BASDAI and CRP(P<0.05).After treatment,the correlation between the above indices disappeared.The areas under ROC curves of MMP-3,TIMP-1 and SPARCC differences were 0.773,0.667 and 0.770,respectively.Conclusion Serum MMP-3, TIMP-1 levels and SPARCC score are of greater significance in evaluating the disease activity and treatment response of axSpA.

关 键 词：中轴型脊柱关节炎 基质金属蛋白酶-3 基质金属蛋白酶抑制剂-1 SPARCC评分 

分 类 号：R593.23[医药卫生—内科学]