血清MMP-3和LYVE1与CCL19水平在阿达木单抗治疗类风湿性关节炎患者疗程中的变化及临床意义  

Changes and clinical significance of serum levels of MMP-3 and LYVE1 and CCL19 in patients with rheumatoid arthritis treated with Adalimumab

作　　者：李占武[1] 邢玲[1] 李桃英[1] 李敏[1] LI Zhan-wu;XING Ling;LI Tao-ying;LI Min(Department of Pharmacy,the Second Affiliated Hospital of Zhengzhou University,Zhengzhou 450014,China)

机构地区：[1]郑州大学第二附属医院药学部,郑州450014

出　　处：《医药论坛杂志》2025年第5期539-543,共5页Journal of Medical Forum

基　　金：河南省医学科技攻关联合共建项目(LHGJ240325);北京医卫健康公益基金会项目(YWJKJJHKYJBXS5-22013)。

摘　　要：目的分析血清基质金属蛋白酶3(matrix metallo proteinase-3,MMP-3)、淋巴管内皮透明质酸受体-1(lymphatic vessel endothelial hyaluronic acid receptor-1,LYVE1)、趋化因子配体19(chemokine ligand 19,CCL19)水平在阿达木单抗治疗类风湿性关节炎患者疗程中的变化及临床意义。方法选取郑州大学第二附属医院2021年1月—2023年11月收治的87例类风湿性关节炎患者为研究对象,根据不同临床疗效分为治疗有效组、治疗无效组,对比2组临床一般资料,对比治疗前及治疗4周时血清MMP-3、LYVE1、CCL19水平变化并分析其相关性,并分析其水平联合检测对患者疗效的预测价值及危险度。结果治疗无效患者治疗前类风湿因子(rheumatoid factor,RF)、红细胞沉降率(erythrocyte sedimentation rate,ESR)、28个关节疾病活动性评分(28 joint disease activity scores,DAS28)水平均高于治疗有效患者(P<0.05);治疗无效患者治疗前及治疗4周时血清MMP-3、CCL19水平均高于治疗无效患者,血清LYVE1水平均低于治疗有效患者(P<0.05);血清MMP-3、CCL19与ESR、RF、DAS28评分均呈正相关,血清LYVE1与ESR、RF、DAS28评分均呈负相关(P<0.05);治疗前、治疗4周时血清MMP-3、LYVE1、CCL19水平联合预测患者治疗无效的曲线下面积(area under the curve,AUC)分别为0.764、0.801(P<0.05);治疗前、治疗4周时血清MMP-3、LYVE1、CCL19高水平患者发生治疗无效的危险度是低水平2.162、0.525、2.695及2.316、0.429、2.625倍(P<0.05)。结论血清MMP-3、LYVE1、CCL19在评估类风湿性关节炎临床疗效中具有重要价值,临床监测其表达可为临床评估类风湿性关节炎临床疗效提供新视角。Objective To analyze the changes and clinical significance of serum levels of matrix metallo proteinase-3(MMP-3),lymphatic vessel endothelial hyaluronic acid receptor-1(LYVE1)and chemokine ligand 19(CCL19)in patients with rheumatoid arthritis treated with Adalimumab.Methods A total of 87 patients with rheumatoid arthritis in our hospital from January 2021 to November 2023 were selected as the research objects,and they were divided into effective treatment group and ineffective treatment group according to different clinical curative effects.The clinical general data of the two groups were compared,and the changes of serum levels of MMP-3,LYVE1 and CCL19 before treatment and 4 weeks after treatment were compared,and the correlation was analyzed,and the predictive value and risk of combined detection of their levels for the curative effect of patients were analyzed.Results The levels of rheumatoid factor(RF),erythrocyte sedimentation rate(ESR)and 28 joint disease activity scores(DAS28)in patients with ineffective treatment were higher than those in patients with effective treatment(P<0.05);the serum levels of MMP-3 and CCL19 in patients with ineffective treatment were higher than those in patients with ineffective treatment before treatment and 4 weeks after treatment,and the serum levels of LYVE1 were lower than those in patients with effective treatment(P<0.05);serum MMP-3 and CCL19 were positively correlated with ESR,RF and DAS28 scores,while serum LYVE1 was negatively correlated with ESR,RF and DAS28 scores(P<0.05);the area under the curve(AUC)of combined prediction of serum levels of MMP-3,LYVEI and CCL19 before and 4 weeks after treatment were 0.764 and 0.801,respectively(P<0.05);the risk of treatment failure in patients with high levels of serum MMP-3,LYVE1 and CCL19 before treatment and 4 weeks after treatment were 2.162,0.525,2.695 and 2.316,0.429,2.625 times higher than those with low levels(P<0.05).Conclusion Serum MMP-3,LYVE1 and CCL19 have important value in evaluating the clinical efficacy of rheumato

关 键 词：MMP-3 LYVE1 CCL19 阿达木单抗 类风湿性关节炎 

分 类 号：R593.22[医药卫生—内科学]