基质金属蛋白酶 -1 mRNA、A-2巨球蛋白 mRNA在创伤性关节炎病人软骨中的表达及与病情严重程度的相关性

目的 探究基质金属蛋白酶-1(MMP-1)mRNA、A-2巨球蛋白(A2M)mRNA在创伤性关节炎(PTOA)病人软骨中的表达及与病情严重程度的相关性.方法 前瞻性选取开封市中心医院2018年1月至2019年6月收治的PTOA病人76例作为PTOA组,另选取同期该院类风湿性关节炎(RA)病人72例作为RA组,比较两组、不同病情分级病人软骨中MMP-1 mRNA、A2M mRNA表达量,受试者工作特征曲线(ROC曲线)及曲线下面积(AUC)分析两者对PTOA、RA鉴别诊断价值,采用logistic回归分析探究MMP-1 mRNA、A2M mRNA与病情严重程度的关系,Pearson分析MMP-1 mRNA、A2M mRNA表达量与膝关节评分法(KSS)、美国特种外科医院(HSS)评分相关性.结果 PTOA组软骨中MMP-1 mRNA为(0.52±0.13),A2M mRNA为(1.06±0.35),分别低于RA组的(0.67±0.16)、(1.53±0.51)(P<0.05);鉴别诊断PTOA、RA的AUC:MMP-1 mRNA+A2M mRNA>A2M mRNA>MMP-1 mRNA;MMP-1 mRNA随病情分级增加呈逐渐升高趋势,A2M mRNA表达量、KSS、HSS评分呈下降趋势(P<0.05);MMP-1 mRNA、A2M mRNA与PTOA病情程度显著相关(P<0.05);MMP-1 mRNA与KSS、HSS评分呈负相关,A2M mRNA表达量与KSS、HSS评分呈正相关(P<0.05).结论 软骨中MMP-1 mRNA、A2M mRNA在PTOA中较RA呈低表达;且前者与病情呈正相关,与关节功能呈负相关,后者则完全相反.调控MMP-1 mRNA、A2M mRNA表达可能为PTOA的治疗提供了一个潜在思路.

Expression of MMP-1 mRNA and A2M mRNA in cartilage of patients with traumatic arthritis and its correlation with the severity of disease

Objective To investigate the expression of matrix metalloproteinase-1 (MMP-1) mRNA and A-2 macroglobulin (A2M) mRNA in cartilage of patients with traumatic arthritis (PTOA) and their correlation with the severity of disease.Methods Prospectiveselection 76 patients with PTOA admitted to Kaifeng Central Hospital from January 2018 to June 2019 were selected as the PTOAgroup, and 72 patients with rheumatoid arthritis (RA) in the hospital during the same period were selected as the RA group. The expression levels of MMP-1 mRNA and A2M mRNA in cartilage of two groups of patients with different disease levels were compared; the receiver operating characteristic (ROC) curve and the area under the curve (AUC) analysis were valuable for the differential diagnosis ofPTOA and RA; Logistic regression analysis was used to explore the relationship between MMP-1 mRNA, A2M mRNA and the severity of disease; Pearson analysis of the correlation between MMP-1 mRNA and A2M mRNA expression and Knee Score (KSS) and American Special Surgery Hospital (HSS) scores.Results MMP-1 mRNA in cartilage in PTOA group was (0.52±0.13) and A2M mRNA was(1.06±0.35), which were lower than those in RA group (0.67±0.16) and (1.53±0.51) (P<0.05)]; differential diagnosis of PTOA, RA AUC: MMP-1 mRNA+A2M mRNA>A2M mRNA>MMP-1 mRNA; MMP-1 mRNA showed a gradual increase trend with the increase ofdisease grade, A2M mRNA expression, KSS, HSS score showed a downward trend (P<0.05); MMP-1 mRNA and A2M mRNA were significantly correlated with the severity of PTOA (P<0.05); MMP-1 mRNA was negatively correlated with KSS and HSS scores, and A2MmRNA expression was positively correlated with KSS and HSS scores (P<0.05).Conclusion MMP-1 mRNA and A2M mRNA in cartilage can be used to diagnose PTAA and RA, and it is significantly related to the disease and joint function of PTOA, regulation of MMP1 mRNA and A2M mRNA expression may provide a potential idea for the treatment of PTOA.