强直性脊柱炎患者MMP-3、MMP-9表达及临床意义

Expression and clinical significance of MMP-3 and MMP-9 in patients with ankylosing spondylitis

目的 观察强直性脊柱炎(AS)患者基质金属蛋白酶-3(MMP-3)、基质金属蛋白酶-9(MMP-9)表达水平,并通过分析其与骨代谢的关系来评价检查MMP-3、MMP-9的临床意义。方法 以我院2017年1月~2019年3月收治的146例AS患者为研究对象,并选取100例健康体检者作为对照组,比较AS组与对照组一般资料(性别、年龄、体质指数)、实验室指标[红细胞沉降率(ESR)、C反应蛋白(CRP)、血清Ca、MMP-3、MMP-9、骨碱性磷酸酶(BALP)、血浆抗酒石酸酸性磷酸酶(TRACP-5b)]及骨密度(BMD,以腰椎为例);观察AS患者不同症状[Bath强直性脊柱炎疾病活动性指数(BASDAI)]、功能状态[Bath强直性脊柱炎功能指数(BASFI)]、BMD水平下血清MMP-3、MMP-9水平表达情况;采用Pearson相关性分析MMP-3、MMP-9与ESR、CRP、血清Ca、BALP、TRACP-5b、BASDAI、BASFI、BMD相关性。结果AS组ESR、血清CRP、TRACP-5b、MMP-3、MMP-9水平均显著高于对照组,腰椎BMD显著低于健康对照组(P<0.05);不同症状严重程度、不同功能状态、不同骨量AS患者血清MMP-3、MMP-9水平表达差异有统计学意义(P<0.05),表现为BASDAI≥6组高于BASDAI<6组、BASFI≥6组高于BASFI<6组、骨量减少组及骨质疏松症组高于骨量正常组,差异均有统计学意义(P<0.05);AS患者血清MMP-3、MMP-9表达水平均与ESR、CRP、BASDAI、BASFI、TRACP-5b呈正相关(P<0.05),与BMD呈负相关(P<0.05)。结论 AS患者血清MMP-3、MMP-9表达水平升高,且与病情活动程度、骨量关系密切,监测MMP-3、MMP-9水平可用来帮助临床分析AS患者病情进展、骨质破坏等情况。

Objective To observe the expression levels of matrix metalloproteinase-3(MMP-3)and matrix metalloproteinase-9(MMP-9)in patients with ankylosing spondylitis(AS)and evaluate the clinical significance of MMP-3 and MMP-9 by analyzing their relationship with bone metabolism.Methods A total of 146 AS patients admitted to our hospital from Jan 2017 to Mar 2019 were enrolled in the study.100 healthy examiners were selected as control group.The general data(gender,age,body mass index),laboratory indicators including erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),serum Ca,MMP-3,MMP-9,bone alkaline phosphatase(BALP),plasma tartrate-resistant acid phosphatase(TRACP-5b)and bone mineral density(BMD,taking lumbar vertebrae as an example)were compared between AS group and healthy control group.The expression levels of serum MMP-3 and MMP-9 were observed among AS patients with different symptoms[Bath ankylosing spondylitis disease activity index(BASDAI)],functional status[Bath ankylosing spondylitis functional index(BASFI)]and BMD level.The correlation between MMP-3 and MMP-9 and ESR,CRP,serum Ca,BALP,TRACP-5b,BASDAI,BASFI and BMD was analyzed by Pearson correlation method.Results The levels of ESR,serum CRP,TRACP-5b,MMP-3 and MMP-9 in AS group were significantly higher than those in control group while the BMD of lumbar vertebrae was significantly lower than that in control group(P<0.05).There were significant differences in the levels of serum MMP-3 and MMP-9 among AS patients with different symptom severity,different functional status and different bone mass(P<0.05).The levels in BASDAI≥6 group were higher than those in BASDAI<6 group,the levels in BASFI≥6 group were higher than those in BASFI<6 group,and the levels in osteopenia group and osteoporosis group were higher than those in normal bone mass group(P<0.05).The expression levels of serum MMP-3 and MMP-9 in AS patients were positively correlated with ESR,CRP,BASDAI,BASFI and TRACP-5b(P<0.05),and were negatively correlated with BMD(P<0.05).Conclusion The expression levels of serum MMP-3 and MMP-9 increase in AS patients,and they are closely related to the degree of disease activity and bone mineral density.Monitoring of MMP-3 and MMP-9 may help to analyze the progression and bone destruction of AS patients in clinical practice.