抗CCP抗体与基质金属蛋白酶3在类风湿关节炎早期诊断中的应用

Applications of anti-cyclic citruUinated peptide antibody and matrixmetalloproteinasis-3 in earlier diagnosis of rheumatoid arthritis

目的观察类风湿性关节炎(RA)早期患者治疗前后血液中抗环瓜氨酸肽(CCP)抗体和基质金属蛋白酶3(MMP-3)的含量变化,评价两者在RA患者早期诊断中的临床价值。方法用酶联免疫吸附试验法对84例早期RA患者、96例非nA患者和26名健康体检者中抗CCP抗体及MMP-3进行检测;结合影像学诊断以及临床跟踪随访情况评价两者与病情活动度、骨侵蚀度的相关性。结果RA早期患者治疗前血液中抗CCP抗体和MMP-3的含量与非RA患者和健康体检者相比均明显升高(P<0．01),治疗后含量均明显降低,与非RA患者和健康体检者相比无显著性差异(P>0．05)。非RA患者抗CCP抗体含量变化不明显,与健康对照组相比MMP-3含量无显著性差异(P>0．05)。结合影像学诊断及跟踪随访发现抗CCP抗体阳性者比抗CCP抗体阴性者病情严重,骨侵蚀明显(X2=5．059,P<0．05),致残率高;MMP-3含量变化与病情活动度有关(r=0．76,P<0．05),活动时含量显著升高,恢复期降低,前后相比有显著性差异(P<0．05)。结论抗CCP抗体与MMP-3含量可作为RA患者早期诊断指标;动态检测两者的血液含量有利于RA的早期干预;联合检测抗CCP抗体和MMP-3在早期发现RA患者、为RA患者的彻底治愈提供理论基础。

Objective To evaluate the earlier diagnosis values of anti-cyclic citrullinated peptide （anti-CCP） antibody and matrixmetalloproteinasis-3 （MMP-3） in patients with rheumatoid arthritis （RA） by investigating the content of anti-cyclic citrullinated peptide antibody and MMP-3 in patients with rheumatoid arthritis in early period before therapy. Methods Serum anti-CCP antibodies and MMP-3 antibodies were detected in 84 cases of RA, 96 cases of non-RA and 26 cases of healthy physical examines by enzyme linked immunosorbent assay （ELISA）. Radiographs of hands and feet in 84 cases with established RA were simultaneously conducted, and sharp scores were also evaluated. Patients were divided into bone-eroded group and non-bone-eroded group based on sharp scores. The correlation between anti-CCP antibodies and the erosion of bone was analyzed. The correlation between MMP-3 and the activity of pathogenetic condition was also assayed, Results The contents of anti-CCP antibodies in RA group before therapy were obviously higher than those in non-RA and healthy control groups （P〈0.01） and significantly declined after therapy. The results of MMP-3 were like the anti-CCP （P〈0.01）. The contents of anti-CCP antibodies and MMP-3 were not significantly different between non-RA and healthy groups （P 〉0.05）. There was a direct correlation between anti-CCP antibodies and the erosion of bone （r=0.87, P〈0.05）, or between MMP-3 and the activity of pathogenetic condition （r=0.76, P〈0.05）. Conclusions Anti-CCP antibodies and MMP-3 can be used as an earlier diagnosis index for patients with RA. Dynamic detection of anti-CCP antibody and MMP-3 in serum may be helpful for the prevention and treatment of RA. Detection of anti-CCP antibodies together with MMP-3 can be helpful to discover patients with RA and provide theoretic bases for their cure.