Structure-modifying capacity of anti-tumour necrosis factor-alpha therapy in ankylosing spondylitis

Spondylarthropathies (SpA) present mainly with spondylitis, pauciarticular peripheral arthritis and enthesopathy. Ankylosing spondylitis (AS) is the prototype disease in this concept. Other entities include reactive arthritis, arthritis in patients with inflammatory bowel disease, some forms of psoriatic arthritis and undifferentiated SpA. NSAIDs are the classical cornerstone of medical therapy in patients with SpA. The effect of these drugs on disease progression, more specifically the ankylosis, is uncertain. Sulfasalazine can be combined with NSAIDs, particularly if peripheral arthritis symptoms persist. However, this combination therapy is not effective for the spondylitis symptoms. Indeed, AS is one of the rheumatic diseases for which no real disease-modifying antirheumatic treatment is available. Challenges in chronic autoimmune arthritis have changed dramatically, especially since biotechnological compounds became available. These compounds allow for a specific intervention in the immune cascade underlying the disease. Tumour necrosis factor (TNF)-alpha antagonists (monoclonal antibodies such as infliximab, or soluble receptors such as etanercept) are the first representative drugs in this category. Open-label studies have shown the efficacy of these new targeted drugs, which has been confirmed by controlled studies, at least in the short term. Improvements in several clinical parameters, function, quality of life, biological parameters, histopathological synovial characteristics and magnetic resonance imaging, have all been observed. As a result of these favourable results, anti-TNFalpha therapy has been approved for the treatment of AS and should be considered for patients with severe axial symptoms and elevated serological markers of inflammatory activity who have responded inadequately to conventional nonsteroidal therapy. There is evidence that this new therapeutic approach has a disease- and even structure-modifying effect in SpA. In this context, structure modification should not only be seen as inhibition of bone and cartilage destruction but more broadly as modulation of tissue histology. Some questions remain unanswered, such as the long-term efficacy and safety of anti-TNFalpha therapy, the extent of structural benefit and the cost effectiveness. However, despite these concerns, anti-TNFalpha therapy represents a major therapeutic advancement in the treatment of AS.     

Swept-source optical coherence tomography analysis in asthmatic children under inhaled corticosteroid therapy

Purpose: To evaluate retinal nerve fiber layer thickness (RNFLT), ganglion cell layer thickness (GCLT), subfoveal choroidal thickness (SFCT), and central retinal thickness (CRT) in asthmatic children who were under inhaled corticosteroid treatment by using Swept-Source Optical Coherence Tomography (SS-OCT).

Material and methods: Fifty-three children were prospectively analyzed in the study. Group 1 included 31 asthmatic children and group 2 included 22 healthy children. Asthmatic children received a dose 250?μg daily of inhaled fluticasone propionate (Flexotide, GlaxoSmithKline, Middlesex, UK). Allergy parameters including, exposure to smoke, eosinophil count, percentage of eosinophils, immunoglobuline (Ig) E levels, number of asthma attacks, number of sensitivity to allergens and follow-up time were recorded. The RNFLT, GCLT, SFCT, and CRT were analyzed with SS-OCT and the data were compared between the groups.

Results: There were 13 girls (41.9%) and 18 boys (58.1%) in group 1 and 13 girls (59.1%) and 9 boys (40.9%) in group 2 (p?=?0.22). The mean age was 9.3?±?2.2 years in group 1 and 9.9?±?1.5 years in group 2 (p?=?0.08). The mean CRT (239.26?±?34.56 µm versus 226.82?±?26.23 µm, p?=?0.22) and mean SFCT (273.97?±?40.95 µm versus 280.41?±?32.78 µm, p?=?0.54) did not significantly differ between the groups. The superior, inferior, and average RNFLT were significantly lower in group 1 than group 2 (p?p?p?Conclusions: The SS-OCT revealed that asthmatic children under inhaled corticosteroid treatment have lower RNFLT than healthy subjects.     

Optical coherence tomography findings in patients with alcohol use disorder and their relationship with clinical parameters

Abstract

Purpose: In our study, we aimed to investigate the ganglion cell-inner plexiform layer thickness (GCIPL), retinal nerve fibre layer thickness (RNFL), mean macular volume (MMV), central macular thickness (CMT), mean macular thickness (MMT), and choroidal thickness (CT) values with optical coherence tomography (OCT) in patients who are diagnosed with alcohol use disorder (AUD).

Materials and methods: The study included 43 patients who were diagnosed with AUD, and 43 healthy controls. Detailed biomicroscopic examinations of all the participants, visual acuity, intraocular pressure, anterior and posterior segment examinations, and then, OCT measurements were carried out.

Results: Although the measured values for RNFL in the superior and temporal quadrant are within normal limits, they were slightly higher compared to those in the control group (p values 0.127 and 0.191 for superior quadrant and temporal quadrant, respectively). The CT measurements in all quadrants were higher than the control group; however, these measurements were not statistically significant (p?>?0.05). When the relation between clinical features and OCT findings of the patients were examined, it was determined that the ages of the patients were statistically significantly and inversely correlated with the temporal CT and also the nasal and temporal quadrants of RNFL.

Conclusions: Our study is the first study that examines the retinal GCIPL and CT with OCT in patients who are diagnosed with AUD. In our results, it was determined that there were no statistically significant differences between the participants in terms of OCT parameters. Further studies with larger sampling groups evaluating neurotransmission findings may provide wider results.     

重组人Ⅱ型肿瘤坏死因子受体-抗体融合蛋白对强直性脊柱炎外周血细胞的影响

目的评价重组人Ⅱ型肿瘤坏死因子受体-抗体融合蛋白(商品名:益赛普)治疗强直性脊柱炎(AS)对患者外周血细胞的影响。方法本研究前6周为随机、双盲、安慰剂对照临床试验,52例AS患者随机接受6周的每周2次益赛普(25 mg)或安慰剂皮下注射;后6周均接受益赛普治疗,于第0、1、2、4、6、7、8、10、12周进行血常规检查及临床疗效评价,分析白细胞总数、中性粒细胞、淋巴细胞、血红蛋白和血小板的变化规律。结果益赛普治疗后第1周,AS患者外周血白细胞总数即较基线时下降(P<0.05),并且有11例患者出现白细胞减少,进一步分析显示益赛普治疗使AS患者中性粒细胞减少、淋巴细胞增多、中性粒细胞减少的程度要高于淋巴细胞增加的程度。临床分析表明白细胞减少与益赛普的疗效无关。同时还发现益赛普治疗可改善AS患者的贫血状态,降低异常升高的血小板。结论益赛普治疗AS在一定程度上可引起患者血液系统的变化,有必要在今后的治疗过程中定期监测血常规。     

Effect of anti-tumor necrosis factor-alpha therapies on body mass index in patients with psoriasis.

Psoriasis is a lifelong, chronic and immune-mediated skin disease affecting approximately 1-3% of the Caucasian population. Pathogenesis of psoriasis is associated with an increased expression of tumor necrosis factor-alpha (TNF-alpha). TNF-alpha is a pro-inflammatory cytokine and important mediator of cachexia. Anti-TNF-alpha therapies are effective in the treatment of psoriasis. The primary end-point was to investigate retrospectively the effect of anti-TNF-therapies on body weight and body mass index (BMI) in patients with psoriasis under treatment with infliximab, etanercept, adalimumab (anti-TNF-alpha group), efalizumab or methotrexate (control group). The patients were treated for 48 weeks. BMI, weight and disease activity were measured at baseline (week 0), weeks 12, 24 and 48. At week 24 a significant increase in body weight and BMI in the anti-TNF-alpha treatment group compared to the control was observed. BMI and body weight did not interfere with the drugs' efficacy. We report a significant weight-gain associated with three different anti-TNF-alpha therapies in a large number of patients affected with psoriasis.     

Retinal structural changes in patients receiving tamoxifen therapy by spectral-domain optical coherence tomography

Abstract

Purpose: To evaluate choroidal thickness, ganglion cell complex (GCC) and photoreceptor outer segment (PROS) length were measured in patients with breast cancer undergoing tamoxifen therapy, using spectral-domain optical coherence tomography (SD-OCT); results were compared with those for normal eyes.

Materials and methods: Forty-four patients with breast cancer, undergoing tamoxifen therapy, and 41 healthy controls were included in this prospective, comparative study. All participants underwent a complete ophthalmologic evaluation and SD-OCT. Subfoveal, nasal (nasal distance to fovea 500, 1000, 1500?μm), and temporal (temporal distance to fovea 500, 1000, 1500?μm) choroidal thickness measurements were performed using the enhanced depth imaging mode of SD-OCT. Using an Early Treatment Diagnostic Retinopathy Study (ETDRS) circle at the macular level, the automated retinal segmentation software was applied to determine the thickness of the GCC. PROS length was determined manually, as the distance from the inner surface of the ellipsoid zone to the inner surface of retina pigment epithelium.

Results: The mean choroidal thickness was statistically greater in the tamoxifen group than controls in all quadrants (p?<?0.001 for all quadrants). Of all tamoxifen users (44 eyes of 44 patients), 33 eyes (75%) had uncomplicated pachychoroid (UCP). Pachychoroid pigment epitheliopathy (PPE) was detected in five tamoxifen-group patients (11.3%). Patients with PPE in one eye had UCP in the fellow eye. Central serous chorioretinopathy findings were observed in one patient. Tamoxifen users had statistically lower GCC thickness in all inner rings of the ETDRS inlay and in the nasal outer ring only (p?=?0.027, 0.002, 0.002, 0.001, and 0.030, respectively). No statistically significant difference in mean subfoveal PROS length was found between the groups.

Conclusions: SD-OCT provides valuable information for identifying structural changes and evaluating ocular findings in patients receiving tamoxifen therapy. Increased choroidal thickness, PPE and thinning GCC were detected in tamoxifen users. These OCT findings may be an early indicator of retinal toxicity for patients undergoing tamoxifen therapy in the follow-up period.     

强直性脊柱炎患者性功能及抑郁状态的研究

目的通过问卷调查的方法,探讨强直性脊柱炎(AS)患者性功能及抑郁状态,并讨论勃起功能障碍(ED)与疾病活动的相关性。方法使用勃起功能国际指数(IIEF)、贝克抑郁量表(BDI),对AS患者性功能及抑郁状况进行评估,并分析AS患者ED与患者年龄、病程、晨僵时间、Bath强直性脊柱炎活动指标(BASDAI)、C反应蛋白(CRP)、红细胞沉降率(ESR)以及抑郁状态的相关性。结果①与健康对照组比较,男性AS患者的勃起功能、性交满意度、性高潮以及总满意度评分均较低,差异有统计学意义(P值分别为0.01,0.00,0.00,0.00),其性欲评分差异无统计学意义(P=0.74)。AS患者抑郁的平均积分较高(4±4),差异有统计学意义(P=0.00)。②经Logistic回归分析,除年龄、晨僵时间外,AS患者的其他临床症状和实验室指标均与ED无相关性。结论 AS患者与健康人群相比,可能伴有性功能减低及抑郁状态。AS患者ED的发生与患者年龄、晨僵呈正相关。     

肿瘤坏死因子拮抗剂在治疗强直性脊柱炎中的安全性分析*

目的：分析肿瘤坏死因子-α拮抗剂在治疗强直性脊柱炎（AS）患者过程中所发生的不良反应，评价其临床应用的安全性和耐受性。方法：对应用英利昔单抗（infliximab）和依那西普（etanercept）治疗期间及随访过程中AS患者所发生的全部不良事件、严重不良事件、实验室检查等进行总结分析，根据世界卫生组织不良反应术语命名（WHOART）系统进行分类，观察不良事件的发生情况。结果：英利昔单抗治疗63例AS患者中，21例（33．33％）患者发生了至少43例次与治疗药物相关的不良反应，主要为上呼吸道感染、皮肤及其附件损害等，2例患者发生严重的皮炎伴脱发，1例在第3次输注药物过程中出现输注反应。共有142例AS患者入选依那西普临床试验，随机分配，治疗组70例，安慰剂组72例，双盲治疗期安慰剂组和依那西普组的不良事件发生率分别为29．17％和40．00％，两组比较差异无统计学意义（P〉0．05），与治疗相关的不良事件安慰剂组和依那西普组分别为20．83％和38．57％；开放治疗期内全部不良事件发生率在安慰剂组和依那西普组分别为41．67％和32．86％，两组比较差异也没有统计学意义（P〉0．05），与药物相关的不良事件分别为40．28％和30．00％；依那西普最常见的不良反应是注射局部反应、皮肤及其附件的损害、白细胞分类中淋巴细胞比例升高和呼吸道感染等。结论：短期临床观察显示，肿瘤坏死因子拮抗剂英利昔单抗和依那西普治疗AS的耐受性和安全性较好。     

强直性脊柱炎外周血Th17细胞的检测及意义

目的 探讨Th17细胞在强直性脊柱炎(AS)患者外周血中的水平及意义.方法 取40例AS患者(分AS病情稳定组、活动组各20例)和健康人外周血单个核细胞(PBMC),免疫磁珠阴选CD4~+ T细胞,用或不用非特异性刺激剂(A-CD3、A-CD28),然后加PMA/Ion,经固定/透膜处理进行细胞内染色,流式细胞术(FCM)检测CD4~+T细胞内白细胞介素17(IL-17~+)/γ于扰素(IFN-γ~+)、IL-17~+/IL-6~+水平.结果 免疫磁珠阴选CD4~+T细胞纯度达90% 以上.AS病情活动组IL-17表达水平较病情稳定组和健康对照组显著增高(P<0.01).用A-CD3、A-CD28和IL-23刺激后,CD4~+ T细胞IL-17胞内表达水平较无刺激有一定的增加.AS患者CD4~+T细胞IFN-γ胞内表达水平呈现卜IL-17表达相似的特点.AS患者IL-17胞内表达水平与IFN-γ和IL-6无显著相关.结论 AS患者外周血CD4~+ T细胞胞内IL-17和IFN-γ高表达,提示分泌IL-17的Th17细胞和分泌IFN-γ的Th1细胞共同参与了AS发病过程.     

综合护理干预在强直性脊柱炎患者中的应用效果

目的：探讨系统功能锻炼及心理干预在强直性脊柱炎（AS）中的应用效果。方法将80例AS患者按照抽签方法随机均分为对照组与观察组,分别给予常规护理干预与康复功能锻炼及心理护理干预。比较两组护理干预前后枕墙距、胸廓扩张度、晨僵时间、疼痛评分及心理状况评分。结果两组患者护理干预前后枕墙距、胸廓扩张度、晨僵时间、疼痛评分相比,差异有统计学意义（P〈0.05）,且两组护理干预后上述指标差异,差异有统计学意义（P〈0.05）;两组护理干预后焦虑自评量表（SAS）及抑郁自评量表（SDS）评分均显著低于护理干预前（P〈0.05或0.01）,且观察组护理干预后SAS及SDS评分均显著低于对照组护理干预后（P〈0.05）。结论与常规护理模式相比,系统的指导功能锻炼及心理护理干预在AS患者中的应用效果显著,患者心理状况改善显著,应加以推广及应用。     

注射用重组人Ⅱ型肿瘤坏死因子受体-抗体融合蛋白对强直性脊柱炎患者血清DKK-1及骨代谢指标的影响

目的:观察注射用重组人Ⅱ型肿瘤坏死因子受体-抗体融合蛋白对强直性脊柱炎(ankylosing spondylitis,AS)患者血清Dickkopf-1蛋白(DKK-1)及骨代谢指标的影响.方法:选取2016年12月至2018年6月华中科技大学同济医学院附属普爱医院诊治的40名AS患者为AS组,另选取同期40名健康体检...     

动态监测骨代谢标志物在诊治强直性脊柱炎中的意义

目的通过对血清骨代谢指标的动态检测探讨其与强直性脊柱炎(AS)发生发展的相关性,为AS的诊断预后及治疗提供客观依据。方法根据AS患者骶髂关节的病损程度分早期、进展期、晚期3期,选择各50例门诊及住院患者。对照组选择年龄及性别相匹配的50名健康对照者,取患者晨起空腹血样,采用电化学发光免疫(ECLIA)及酶联免疫吸附试验(ELISA)检测骨代谢相关指标:甲状旁腺素(PTH),总Ⅰ型前胶原氨基末端(N端)前肽(tPINP),骨钙素N端中分子片段(N-MID OT),I型胶原C端肽(β-CTX),25-羟基维生素D3[25-(OH)D3],Ⅰ型胶原交联羧基末端肽(ICTP)。对3期各组间数据进行比较及相关分析。结果①AS组血清中NMID OT、25-(OH)D3低于健康对照组,β-CTX、ICTP高于健康对照组,组间比较差异均有统计学意义(P<0.01);tPINP、PTH浓度水平在AS患者组与健康对照组组间无显著差异性(P>0.05)。②AS晚期组血清中N-MID OT、25-(OH)D3低于早期组,组间比较差异具有统计学意义(P<0.05);晚期组β-CTX、ICTP浓度水平高于早期组,组间比较差异均有统计学意义(P<0.05);晚期组与早期组tPINP、PTH在组间差异无统计学意义(P>0.05);随着AS疾病的进展,血清中N-MID OT、25-(OH)D3浓度水平逐渐降低,β-CTX、ICTP浓度水平显著升高。结论血清骨代谢指标在分期不同的AS患者中存在异常,不同指标参与了AS的骨吸收及骨转换过程,可为AS的诊断预后及治疗提供客观依据。     

CRP、免疫球蛋白联合检测在强直性脊柱炎诊断中的应用

目的 探讨C-反应蛋白(CRP)、免疫球蛋白在强直性脊柱炎(AS)患者中的水平变化及其对AS的影响.方法 采用免疫散射比浊法检测31例强直性脊柱炎患者与40例正常健康人血清中CRP、免疫球蛋白的水平进行比较.结果 CRP、IgA、IgG水平显著高于正常对照组(P<0.01),IgM水平与健康对照组无显著性差异(P＞0.01).结论 CRP、IgA IgG参与强直性脊柱炎的发病、发展过程,通过观察CRP、IgA、IgG的变化对强直性脊柱炎的病情活动性判断和疗效估计有重要意义.     

Andrological findings in young patients under long-term antidepressive therapy with clomipramine

Serum hormone levels of follicle stimulating hormone (FSH), luteotropic hormone (LH), testosterone (T), prolactin (hPRL), estradiol (E₂) and GnRH test were carried out in 11 patients after antidepressive therapy with clomipramine at a dosage of 75 mg/day for 3 months. Nine of these patients agreed with the evaluation of ejaculate parameter. As an age matched control group 15 patients without psychiatric disorders but under urological treatment because of erectile dysfunction were investigated in the same manner, with 11 patients being able to produce an ejaculate for examination. Both groups were closely comparable caccording to age, percentage of proven fertility and urological status. All spermiograms evaluated in the clomipramine group were pathological, especially with regard to volume, sperm motility and sperm morphology, whereas only 37% in the control group showed pathological findings, approximately the same as that of healthy individuals in this age range. Serum hormone levels as well as the hypothalamic-hypophyseal-gonadal axis proven with the Gn-RH test were in normal range in both groups. According to these results it seems evident that clomipramine does not alter sexual hormone profiles in males or interfere with the hypothalamic-hypophyseal-gonadal axis and has a significant negative effect on ejaculate parameters.     

Higher frequency of peripheral blood follicular regulatory T cells in patients with new onset ankylosing spondylitis

Follicular helper T (TFH) cells and B cells are linked to the pathogenesis of ankylosing spondylitis (AS). Follicular regulatory T (TFR) cells suppress TFH cell and germinal center B cell numbers in vivo. The role of TFR cells in AS is unknown. The frequency of peripheral blood inducible FOXP3+CXCR5+CD4+TFR cells and CXCR5+CD4+TFH cells were taken from 20 onset AS patients and 10 healthy controls, and were examined by flow cytometry, their disease activity were measured by the Bath Ankylosing Spondylitis Disease Activity Index. The concentrations of serum interleukin (IL)‐21, immunoglobulin G, immunoglobulin A, immunoglobulin M and C‐reactive protein were examined, and the values of erythrocyte sedimentation rate were measured. The frequency of peripheral blood FOXP3+CXCR5+CD4+TFR cells, CXCR5+CD4+TFH cells, the ratio of FOXP3+CXCR5+CD4+TFR/CXCR5+CD4+TFH cells and the concentration of serum IL‐21 in the AS patients were significantly higher than those in the healthy controls (P < 0.0001, P = 0.0027, P < 0.0001, P = 0.0039, respectively). The frequency of FOXP3+CXCR5+CD4+TFR cells and the ratio of FOXP3+CXCR5+CD4+TFR/CXCR5+CD4+TFH cells still significantly rose in those patients after standard treatment (P = 0.0006, P < 0.0001), the concentration of serum IL‐21 decreased after treatment (P = 0.0049), accompanied by significantly minimized disease activities. Furthermore, the TFR cells were negatively correlated with serum immunoglobulin A in those patients before treatment (r = ?0.582, P = 0.0071), and the frequency of TFR cells was negatively correlated with that of TFH cells and the concentration of serum IL‐21 after treatment (r = ?0.550, P = 0.046; r = ?0.581, P = 0.0371). TFR cells might participate in the pathogenesis of AS, and might be responsible for controlling the autoantibodies, the frequency and function of TFH cells to inhibit the development of AS.     

阿仑膦酸钠在强直性脊柱炎治疗中对骨及软骨代谢指标的影响

目的 探讨阿仑膦酸钠在强直性脊柱炎(AS)治疗中对骨及软骨代谢指标的影响.方法 选取AS患者63例,应用随机数字表法分为观察组32例和对照组31例,两组均进行常规治疗,给予来氟米特联合非甾体类抗炎药物(双氯芬酸钠、美洛昔康等)以及钙剂.观察组在对照组治疗基础上加用阿仑膦酸钠.观察并分析两组患者治疗前后血清软骨寡聚基质蛋白(COMP)、骨特异性碱性磷酸酶(BALP)、抗酒石酸酸性磷酸酶异构体5b(TRACP-5b)、骨桥蛋白(OPN)的含量及炎性指标C-反应蛋白(CRP)、红细胞沉降率(ESR)情况.结果 两组治疗前后各项指标差异无统计学意义(P＞0.05);治疗后观察组COMP(4.29±1.41) μg·L-1、TRACP-5b(38.26±13.47) ng·L-1、OPN(26.90±11.07) μg·L-1水平明显低于治疗前COMP(7.48±3.20) μg·L-1、TRACP-5b(49.10±14.10) ng·L-1、0PN(35.51±13.63) μg · L-1(P＜0.05),且治疗后观察组低于对照组COMP(6.91 ±2.81) μg· L-1、TRACP-5b(44.80±10.50) ng·L-1、OPN(32.90±11.69) μg·L-1 (P ＜0.05);治疗前两组CRP、ESR差异无统计学意义(P＞0.05),治疗后两组CRP、ESR均较治疗前明显降低(P＜0.05),观察组CRP(6.10±1.42) mg·L-1、ESR(41.42±15.86) mm·h-1较对照组[(25.24±10.68) mg· L-1(50.23±16.35) mm·h-1]降低更明显(P＜0.05).结论 阿仑膦酸钠在AS治疗中,能够抑制患者骨吸收和软骨破坏,使AS患者的骨及软骨代谢异常得以改善,在病情控制中起到一定作用,且安全性高.     

Effect of antitumour necrosis factor-alpha therapy on bone turnover in patients with active Crohn's disease: a prospective study

BACKGROUND AND AIMS: Patients with Crohn's disease are at increased risk of osteoporosis. Disease activity and circulating proinflammatory cytokines are thought to play a role in this process. Infliximab, a chimaeric antitumour necrosis factor-alpha antibody is effective in the treatment of Crohn's disease. The aim of this study was to investigate the impact of treatment with infliximab on bone turnover in Crohn's disease patients. METHODS: This was a prospective trial. Twenty-four patients with active Crohn's disease were treated with infliximab (5 mg/kg). Bone markers were assayed pre- and post-treatment. Bone formation was measured using serum bone-specific alkaline phosphatase and total osteocalcin and bone resorption using serum N-telopeptide cross-linked type 1 collagen. RESULTS: Infliximab therapy caused a significant increase in both markers of bone formation in patients with active Crohn's disease. No significant change in the bone resorption marker serum N-telopeptide cross-linked type 1 was found. CONCLUSION: Infliximab therapy had a significant beneficial effect on bone metabolism in patients with active Crohn's disease. These findings further support the theory that active ongoing inflammation and high levels of circulating cytokines play a pivotal role in the pathogenesis of bone loss in patients with Crohn's disease.     

强直性脊柱炎患者血清基质金属蛋白酶-3水平及意义

目的探讨强直性脊柱炎(AS)患者血清基质金属蛋白酶-3(MMP-3)的水平及意义,为临床治疗、判断预后提供新的理论依据。方法采用酶联免疫吸附实验(ELISA)测定175例AS患者(就诊前6个月内未用过慢作用药及糖皮质激素)和95名健康对照者血清MMP-3的水平,同时测定其治疗前的其他实验室指标:红细胞沉降率(ESR)、C反应蛋白(CRP)、白细胞介素6(IL-6)、肿瘤坏死因子α(TNF-α)、骶髂关节X线。分析它们与MMP-3的相关性。结果 AS患者血清MMP-3水平[(226±169)ng/ml]明显高于健康对照组[(53±21)ng/ml],P<0.05;不同临床特点AS患者血清MMP-3水平差异无统计学意义(P>0.05);MMP-3水平与AS患者的ESR、C反应蛋白(CRP)、患者血清CRP、BASDAI评分、白细胞介素6(IL-6)、TNF-α呈正相关(P<0.05);而与发病年龄、病程、晨僵时间、X线分级无明显关系(P>0.05)。结论 MMP-3在AS患者血清中高水平存在。它既能够反映AS关节骨质破坏,又能更好地反映疾病活动程度,可作为除ESR、CRP外提示AS疾病进展与改善的血清学指标。