论文部分内容阅读
目的探讨类风湿关节炎(RA)患者血清基质金属蛋白酶-9(matrix metalloproteinase-9,MMP-9)的水平及意义。方法采用双抗体夹心酶联免疫吸附试验(ELISA)测定50例RA患者(就诊前6个月内未用过慢作用药及糖皮质激素)和18名正常健康对照者的血清MMP-9水平,并选取20例患者进行治疗后的MMP-9测定,比较不同时期MMP-9的水平。同时测定其治疗前的其他实验室及临床指标:类风湿因子(RF)-IgM、血沉(ESR)、抗环瓜氨酸肽抗体(抗CCP抗体)、抗角蛋白抗体(AKA)、抗核周因子(APF)、压痛关节数、疼痛关节数、肿胀关节数及手X线片,分析它们与MMP-9变化的相关性。结果RA患者血清MMP-9水平[(566±175)ng/ml]明显高于正常对照组[(340±246)ng/ml],P<0.01;RA活动期血清MMP-9水平[(894±357)ng/ml]高于缓解期[(438±302)ng/ml],P<0.01;治疗后血清MMP-9水平[(489±359)ng/ml]与治疗前水平[(902±407)ng/ml]相比,差异有统计学意义(P<0.01)。MMP-9水平与RA患者的ESR(P<0.01)、疾病活动分数(DAS)评分(P<0.01)、压痛关节数(P<0.05)、疼痛关节数(P<0.01)、肿胀关节数(P<0.01)、X线分期(P<0.05)呈正相关;而与年龄、病程、晨僵时间、功能分级、AKA、APF、RF、抗CCP抗体水平无明显相关性(P>0.05)。结论MMP-9在RA患者血清中高水平存在提示RA关节骨质破坏和疾病活动程度,可作为除ESR、C反应蛋白(CRP)外提示RA疾病进展与改善的血清学指标。
Objective To investigate the level and significance of serum matrix metalloproteinase-9 (MMP-9) in patients with rheumatoid arthritis (RA). Methods Serum levels of MMP-9 in 50 patients with RA (6 months before treatment were not treated with slow acting drugs and glucocorticoids) and 18 healthy controls were measured by double antibody sandwich enzyme-linked immunosorbent assay (ELISA) Twenty patients were selected for MMP-9 after treatment, and the levels of MMP-9 in different periods were compared. At the same time, other laboratory and clinical indexes before treatment were determined: rheumatoid factor (RF) -IgM, ESR, anti-cyclic citrullinated peptide antibody (anti-CCP), anti-keratin antibody Week rate (APF), the number of tender joints, the number of painful joints, the number of swollen joints and the hand X-ray film, and their correlations with the changes of MMP-9. Results The serum level of MMP-9 in patients with RA was significantly higher than that in controls [(566 ± 175) ng / ml vs (340 ± 246) ng / ml, P <0.01) ± 357 ng / ml] was higher than that in the remission stage [(438 ± 302) ng / ml], P <0.01. The level of serum MMP-9 after treatment [489 ± 359 ng / ml] ± 407) ng / ml], the difference was statistically significant (P <0.01). The levels of MMP-9 in patients with RA were significantly lower than those in patients with RA (P <0.01), disease activity score (DAS), tenderness joint count (P <0.05), pain joint count There was no significant correlation between age, course of disease, morning stiffness, functional grading, AKA, APF, RF, anti-CCP antibody levels (P> 0.05). Conclusion The high level of MMP-9 in the serum of RA patients may indicate the degree of bone destruction and disease activity in RA joints. It may serve as a serological indicator of progression and improvement of RA in addition to ESR and C-reactive protein (CRP).