血清基质金属蛋白酶3在类风湿关节炎中的临床研究

Clinical value of matrix metalloproteinases-3 in rheumatoid arthritis

目的探讨血清基质金属蛋白酶3(MMP-3)与类风湿关节炎(RA)的相关性和临床价值。方法采用回顾性研究,收集2019年1月至2020年1月来北京市石景山医院就诊的RA病例123例,其中男25例,女98例,中位数年龄60岁;同期来院健康体检者53名,其中男12名,女41名,中位数年龄55岁。检测所有受试者的空腹外周血的MMP-3、红细胞沉降率(ESR)、超敏C反应蛋白(hs-CRP)、类风湿因子(RF)、抗环瓜氨酸肽抗体(ACCP)水平,记录28关节疾病活动度评分(DAS28)。采用t检验、Spearman相关分析及ROC曲线等统计方法,分析两组结果差异、相关性分析及血清MMP-3对RA的诊断效能。结果 RA组血清MMP-3水平为(79.71±123.54)ng/ml,明显高于对照组的(26.30±14.83)ng/ml,差异有统计学意义(t=-4.95,P<0.001)。RA组患者血清MMP-3与ESR、hs-CRP、DAS28均具有显著正相关(r值分别为0.521,0.372,0.405,P值均<0.001)。血清MMP-3诊断RA的曲线下面积(area under the curve,AUC)为0.765,取诊断界限值为32.5 ng/ml时,敏感度为64.44%,特异度为75.76%。结论 RA患者血清MMP-3水平显著升高,与RA疾病活动度高度相关,可能对RA的早期诊断、治疗监测及疾病预警有重要的作用。

Objective To analyze the relationship and clinical value between serum matrix metalloproteinases-3(MMP-3)and rheumatoid arthritis(RA).Methods By using retrospective study to collect 123 patients with RA diagnosed in our hospital from January 2019 to January 2020 as the RA group.Among the patients,there are 25 males and 98 females,the median age is 60 years old.During the same term,53 healthy people were selected as the control group,with 12 males and 41 females,the median age is 55 years old.MMP-3,erythrocyte sedimentation rate(ESR),high sensitivity C-reactive protein(hs-CRP),rheumatoid facotrs(RF),anti-cyclocitrulline factor(ACCP)in peripheral blood of all subjects were detected.Disease activity score of 28 joints(DAS28)were collected.This research used T test,Spearman correlation analysis and receiver operating characteristic curve(ROC curve)to analyze the relationship between MMP-3 and other clinical biochemical indices,and the efficacy of MMP-3 in the diagnosis of RA.Results Compared with the control group(26.30±14.83)ng/ml,the levels of serum MMP-3 in the RA group(79.71±123.54)ng/ml had significantly increased(t=-4.95,P<0.001).The serum concentration of MMP-3 in RA patients was significantly correlated with ESR,hs-CRP and DAS28(r value were 0.521,0.372,0.405 respectively,P<0.001).The area under the curve(AUC)of MMP-3 to diagnose RA was 0.765,and the sensitivity was 64.44%,and the specificity was 75.76%,cut-off of MMP-3 were 32.50 ng/ml.Conclusions The levels of serum MMP-3 in the RA group had significantly increased.MMP-3 and the disease activity were highly correlated.MMP-3 can be used as an indicator of RA disease activity,also can significantly improve the diagnostic efficacy,treatment and warning of early RA.