基质金属蛋白酶9对系统性红斑狼疮预后的影响

Effects of Matrix Metalloproteinase-9 in Patients with Systemic Lupus Erythematosus

目的探讨基质金属蛋白酶9(MMP-9)对系统性红斑狼疮(SLE)预后的指导意义。方法选取2008年3月至2011年5月重庆市急救医疗中心收治的SLE患者83例,按照狼疮活动计算标准评价患者疾病活动积分并进行分组:积分>2分纳入SLE活动组(62例),积分≤1分纳入SLE稳定组(21例),另外同期选择80例健康体检者作为正常对照组。比较3组受试者的MMP-9水平及SLE患者治疗前后的MMP-9水平。结果 3组受试者MMP-9水平比较差异有统计学意义(P<0.01),且SLE活动组和SLE稳定组MMP-9水平显著低于正常对照组(P<0.05)。治疗前SLE患者MMP-9水平为(78±16)g/L,治疗后为(79±17)g/L,差异无统计学意义(P>0.05)。SLE患者MMP-9与其24 h尿蛋白、系统性红斑狼疮疾病活动度评分、抗ds-DNA呈明显负相关(r=-0.517,-0.832,-0.439,均P<0.05),与C3、C4呈明显正相关(r=0.355,0.360,均P<0.05)。结论患者外周血MMP-9水平下降提示机体炎性组织和受损血管中MMP-9水平上升,预后较差。

Objective To explore the matrix metalloproteinase 9（ MMP-9） guidance for systemic lupus erythematosus（ SLE） prognosis. Methods A total of 83 patients with SLE treated in Chongqing Emergency Medical Center from Mar. 2008 to May 2011 were selected,the lupus activity was calculated in accordance with the criteria to evaluate disease activity to group the patients： scores 〉2 into active SLE group（ 62cases）,scores≤1 into stable SLE group（ 21 cases）,and another 80 healthy persons during the same period were chosen as normal control group. MMP-9 levels of the three groups and of SLE patients before and after treatment were compared. Results The MMP-9 level of 3 groups had statistically significant differences（ P 0. 01）,and the activities of active SLE group and stable SLE group were significantly lower than the normal control group（ P〉0. 05）. MMP-9 levels in patients with SLE before treatment was（ 78 ± 16） g / L,after treatment was（ 79 ± 17） g / L,the difference was not statistically significant（ P〈0. 05）. MMP-9 was significantly negatively correlated with 24 h urine protein,systemic lupus erythematosus disease activity score,antids-DNA（ r =- 0. 517,- 0. 832,- 0. 439,all P〈0. 05）,and was significantly positively correlated with C3,C4（ r = 0. 355,0. 360,all P〈0. 05）. Conclusion MMP-9 levels in SLE patients is decreased,suggesting that MMP-9 content increases in the inflammatory tissue and damaged blood vessels,and the prognosis is poor.