强直性脊柱炎患者外周血Dickkopf-1相关蛋白、基质金属蛋白酶3水平的临床意义

Detection and clinical significance of peripheral blood Dickkopf-related protein 1 and matrix metalloproteinase-3 levels in patients with ankylosing spondylitis

目的分析强直性脊柱炎(AS)患者外周血Dickkopf-1相关蛋白(DKK-1)、基质金属蛋白酶3(MMP-3)水平的临床意义。方法本研究为回顾性队列研究,选取2021年5月至2023年5月北京中医药大学孙思邈医院经检验科检验的98例AS患者,男65例,女33例,年龄(41.56±11.82)岁,年龄范围为18~65岁。检测患者外周血DKK-1和MMP-3水平,采用Spearman相关系数分析患者外周血DKK-1、MMP-3水平与关节病变严重程度分级的相关性,采用Pearson相关性分析患者外周血DKK-1、MMP-3水平与AS病情活动情况的相关性。结果根据X线检查关节病变严重程度分级,将患者分为Ⅰ级组(n=23)、Ⅱ级组(n=28)、Ⅲ级组(n=26)、Ⅳ级组(n=21)。DKK-1水平比较,Ⅰ级组[(984.21±63.98)pg/ml]>Ⅱ级组[(861.56±36.77)pg/ml]>Ⅲ级组[(756.75±30.87)pg/ml]>Ⅳ级组[(610.67±58.22)pg/ml],差异有统计学意义(P<0.05);MMP-3水平比较中,Ⅰ级组[(40.42±7.89)pg/ml]<Ⅱ级组[(53.43±3.98)pg/ml]<Ⅲ级组[(65.98±4.20)pg/ml]<Ⅳ级组[(81.47±5.41)pg/ml],差异有统计学意义(P<0.05)。经Spearman相关性分析,患者外周血DKK-1水平与X线检查关节病变严重程度分级呈负相关(r=-0.689,P=0.002),MMP-3水平与X线检查关节病变严重程度分级呈正相关(r=0.711,P=0.001)。根据巴斯强直性脊柱炎疾病活动指数(BASDAI)评分将患者AS病情活动情况分为静止期组(n=59,BASDAI评分<4分)与活动期组(n=39,BASDAI评分≥4分),活动期组患者外周血DKK-1水平[(729.64±124.27)pg/ml]低于静止期组[(861.09±124.96)pg/ml],MMP-3水平[(70.38±11.59)μg/L]高于静止期组[(52.67±13.76)μg/L],差异有统计学意义(P<0.05)。经Pearson相关性分析,患者外周血DKK-1水平与AS病情活动情况呈负相关(r=-0.706,P=0.001),MMP-3水平与AS病情活动情况呈正相关(r=0.735,P<0.001)。结论AS患者外周血DKK-1、MMP-3水平与其病情严重程度、疾病活动情况密切相关,为临床及时诊治提供客观依据。

Objective To analyze the clinical significance of peripheral blood Dickkopf-related protein 1(DKK-1)and matrix metalloproteinase-3(MMP-3)levels in patients with ankylosing spondylitis(AS).Methods This study was a retrospective cohort study,a total of 98 patients with AS examined by the Clinical Laboratory in Sun Simiao Hospital of Beijing University of Chinese Medicine were included from May 2021 to May 2023,including 65 males and 33 females,with age of(41.56±11.82)years old,ranging from 18 to 65 years old.The levels of DKK-1 and MMP-3 in peripheral blood were detected.Spearman correlation analysis model was used to analyze the correlation between levels of peripheral blood DKK-1 and MMP-3 and severity of joint lesions.Pearson correlation analysis model was performed to analyze the correlation between levels of peripheral blood DKK-1 and MMP-3 and disease activity of AS.Results According to the severity of joint lesions by X-ray examination,the patients were divided into grade Ⅰ group(n=23),grade Ⅱ group(n=28),grade Ⅲ group(n=26),and grade Ⅳ group(n=21).Comparison of DKK-1 level was shown as grade Ⅰ group[(984.21±63.98)pg/ml]>grade Ⅱgroup[(861.56±36.77)pg/ml]>gradeⅢgroup[(756.75±30.87)pg/ml]>grade Ⅳ group[(610.67±58. 22)pg/ml],and the difference was statistically significant(P<0.05),while comparison of MMP-3 level revealed gradeⅠgroup[(40.42±7.89)pg/ml]<grade Ⅱ group[(53.43±3.98)pg/ml]<grade Ⅲ group[(65.98±4.20)pg/ml]<grade Ⅳ group[(81.47±5.41)pg/ml],and the difference was statistically significant(P<0.05).Spearman correlation analysis showed that the level of DKK-1 in peripheral blood of patients was negatively correlated with severity of joint lesions by X-ray examination(r=-0.689,P=0.002),and the level of MMP-3 was positively correlated with severity of joint lesions by X-ray examination(r=0.711,P=0.001).By means of bath ankylosing spondylitis disease activity index(BASDAI)score,the patients were classified into rest group(n=59,BASDAI score<4 points)and active group(n=39,BASDAI score≥4 points).The level of peripheral blood DKK-1 in active group[(729.64±124.27)pg/ml]was lower than that in rest group[(861.09±124.96)pg/ml],while the level of MMP-3[(70.38±11.59)μg/L]was higher compared to rest group[(52.67±13.76)μg/L],and the difference was statistically significant(P<0.05).Pearson correlation analysis revealed that the level of peripheral blood DKK-1 was negatively correlated with activity of AS(r=-0.706,P=0.001),and the level of MMP-3 was positively correlated with activity of AS(r=0.735,P<0.001).Conclusions The levels of DKK-1 and MMP-3 in peripheral blood of AS patients are closely related to the disease severity and activity,and can provide an objective basis for timely clinical diagnosis and treatment.