MMP 3在评估痛风性关节炎骨侵蚀中的临床应用

The Clinical Application of MMP 3 in Evaluating BoneErosion in Gouty Arthritis

目的探讨血清基质金属蛋白酶-3(MMP-3)在痛风性关节炎合并有痛风石患者中发生骨侵蚀的临床应用研究。方法采用回顾性研究方法,依据2015年美国风湿病学会/欧洲抗风湿联盟痛风分类标准以及痛风发作关节的X线、肌骨超声或双源CT检查结果,收集2022年6月至2023年3月于南京市第一医院风湿免疫科就诊的159例痛风性关节炎患者,分为无骨侵蚀组85例及有骨侵蚀组74例。采用乳胶增强免疫比浊法检测两组血清MMP 3水平,比较两组血清MMP 3水平的差异,综合影像学结果,评估血清MMP 3水平对痛风性关节炎患者骨侵蚀的评价及预测效能,分析痛风性关节炎患者骨侵蚀发生的影响因素。结果有骨侵蚀组血清MMP 3水平显著高于无骨侵蚀组150.31(74.99,216.55)ng/mL vs 60.15(43.58,75.34)ng/mL,差异具有统计学意义(P<0.001)。血清MMP 3水平预测痛风性关节炎患者骨侵蚀的最佳截断值为118.19ng/mL,曲线下面积(AUC)为0.811。多因素Logistic回归分析结果显示血清MMP 3水平是痛风性关节炎患者发生骨侵蚀的独立危险因素(OR=1.04,95%CI 1.02~1.07,P<0.001)。结论血清MMP 3水平与痛风性关节炎患者骨侵蚀的发生密切相关,对于痛风性关节炎骨侵蚀的预测提供一定依据,具有临床应用价值。

Objective To explore the clinical application of serum matrix metalloproteinase 3(MMP 3)in patients with gouty arthritis complicated with tophi.Methods A retrospective study was conducted to collect 159 gouty arthritis patients who attended the Department of Rheumatology and Immunology of the First Hospital of Nanjing from June,2022 to March,2023.Patient diagnosis was based on the 2015 American College of Rheumatology/European League Against Rheumatism(ACR/EULAR)gout classification criteria as well as the X-ray,musculoskeletal ultrasonography,or dual-energy computed tomography(DECT)findings of gouty attacked joints.All patients were then classified into the group without bone erosion(85 cases)and the group with bone erosion(74 cases).Serum MMP 3 levels of the two groups were detected by latex enhanced immunoturbidimetry and then compared.The prediction efficacy of serum MMP 3 levels on bone erosion in gouty arthritis patients were evaluated based on the imaging results,and the influencing factors of bone erosion in gouty arthritis patients were analyzed.Results Serum MMP 3 level in the group with bone erosion was significantly higher than that in the group without bone erosion,with 150.31(74.99,216.55)vs 60.15(43.58,75.34)ng/mL(P<0.001).The optimal cutoff value of serum MMP 3 for predicting bone erosion in gouty arthritis patients was 118.19ng/mL,and the area under the curve(AUC)was 0.811.Multivariate logistic regression analysis showed that serum MMP 3 level was an independent risk factor for bone erosion in gouty arthritis patients(OR=1.04,95%CI 1.02-1.07,P<0.001).Conclusion Serum MMP 3 level is closely related to the occurrence of bone erosion in gouty arthritis patients,which provides knowledge basis for the prediction of bone erosion in gouty arthritis and has a clinical application value.