强直性脊柱炎患者外周血miR-17和基质金属蛋白酶3表达及其临床意义

Expression and clinical significance of miR-17 and MMP-3 in patients with ankylosing spondylitis

目的 探讨miR-17和基质金属蛋白酶3（MMP-3）在强制性脊柱炎（AS）患者血浆、外周血单个核细胞（PBMC）表达及其临床意义。方法 选取2015年1月-2017年6月AS患者60例作为研究组,同期健康体检者60例作为对照组,qRT-PCR检测血浆及PBMC中miR-17,酶联免疫吸附（ELISA）法检测MMP-3的表达。ROC曲线分析评价其对AS诊断灵敏度及特异度。结果 患者血浆、PBMC中miR-17表达水平降低,其在血浆中表达低于PBMC,两者存在正相关（r=0. 736,P 〈0. 01）; MMP-3表达水平显著升高,疾病活动期高于稳定期。miR-17、MMP-3与BASDAI、HLA-B27、CRP及ESR呈正相关（r值分别为-0. 698、-0. 497、-0. 703、-0. 662、-0. 578,0. 654、0. 798、0. 660、0. 763,P 〈0. 01）。ROC曲线分析表明miR-17及MMP-3对AS具有较高诊断灵敏度和特异度,联合检测能提高对AS的诊断能力。结论 miR-17及MMP-3在AS外周血中存在差异表达,有望成为新的临床诊断指标。

Objective To investigate the expressions and their clinical significance of miR - 17 and matrix metalloproteinase - 3 （MMP -3） in plasma and peripheral blood mononuclear cells（PBMC） in patients with acute spondylitis（AS）. Methods Sixty AS patients from January 2015 to June 2017 were selected as the study group. Sixty healthy subjects were selected as the control group, qRT - PCR was used to detect miR - 17 in plasma and PBMC. ELISA was used to detect the expression of miR - 3. ROC curve analysis was used to evaluate the sensitivity and specificity of AS diagnosis. Results The expressions of miR - 17 in plasma and PBMC decreased, and the expression in plasma was lower than that in PBMC. There was a positive correlation between them （ r = 0. 736, P 〈 0.01 ）. The expression of MMP - 3 significantly increased, which was higher in activity period than that in stable period. There was a positive correlation between miR - 17, MMP -3 and BASDAI, HLA - B27, CRP, ESR （r= -0.698, r= -0.497, r= -0.703, r= -0.662, r= -0.578, r=0.654, r=0.798, r=0.660, r= 0. 763, P 〈0.01 ）. ROC curve analysis showed that miR - 17 and MMP -3 had high diagnostic sensitivity and specificity for AS, and combined detection can improve the diagnostic ability of AS. Conclusion miR - 17 and MMP - 3 are differentially expressed in peripheral blood, which is expected to be a new clinical diagnostic index.