系统性红斑狼疮患者血清基质金属蛋白酶-9的检测

Serum Levels of Matrix Metalloproteinases-9 in Patients with Systemic Lupus Erythematosus

目的检测系统性红斑狼疮(SLE)患者血清基质金属蛋白酶-9(MMP-9)和金属蛋白酶组织抑制物-1(TIMP-1)水平并探讨其临床意义。方法MMP-9和TIMP-1检测采用ELISA方法。结果①SLE患者血清MMP-9平均中位数水平为65.00ng/mL显著低于正常人对照组267.50ng/mL(P<0.001)。②SLE患者中,血清MMP-9水平活动组低于非活动组(P<0.05),肾损组低于非肾损组(P<0.01),低补体C3血症者低于无低补体C3血症者(P<0.05),低血清白蛋白血症者低于非低白蛋白血症者(P<0.05),外周血白细胞计数降低者低于无白细胞降低者(P<0.01)。③糖皮质激素治疗后患者MMP-9水平高于治疗前(P<0.05)。④患者MMP-9水平与SLE疾病活动指数(SLEDAI)呈负相关(P<0.01),与C3(P<0.05)、白细胞(P<0.01)、白蛋白/球蛋白比值(P<0.05)呈正相关。⑤血清TIMP-1水平在SLE组与对照组、SLE各相关组之间差异均无显著性。结论MMP-9可能参与SLE发病机制。

Objective To determine the serum levels of matrix metalloproteinase-9 (MMP-9) and tissue inhibitor of metalloproteinase-1 (TIMP-1) in patients with systemic lupus erythematosus (SLE) and their clinical significances. Methods The serum concentrations of MMP-9 and TIMP-1 were measured by ELISA in 46 patients with SLE and age- and sex-matched normal controls. Results ①Serum levels of MMP-9 was significantly decreased in patients with SLE compared with those in normal controls (P < 0.001). ②In SLE patients, serum levels of MMP-9 were significantly decreased in patients with active diseases and renal involvement compared with those in patients with inactive diseases and no renal involvement (P < 0.05 and P < 0.01, respectively). Serum levels of MMP-9 were also significantly decreased in SLE patients with the following abnormalities: decreased C3 (P < 0.05), hypoalbuminemia (P < 0.05) and leucocytopenia (P < 0.01). ③Serum levels of MMP-9 were markedly increased in 11 patients after treatment with steroids (P < 0.05). ④Serum levels of MMP-9 had negative correlation with SLEDAI scores (P < 0.01), and positive correlation with serum C3 levels (P < 0.05), white blood cell counts (P < 0.01), and serum albumin-globulin ratio (P < 0.05). ⑤No significant differences of serum TIMP-1 levels were found between patients with SLE and healthy controls, and between different groups of SLE. Conclusions The results suggest that MMP-9 may play certain roles in the pathogenesis of SLE. Serum MMP-9 level could be used as an indicator for measuring disease activity of SLE, observing renal involvement and evaluation of therapeutic efficacy of steroids.