骨关节炎患者血清和滑液中金属蛋白酶-2和-9的研究

目的 探讨金属蛋白酶－2和－9与骨关节炎实验室指标和膝关节X线分级的相关必,以了解两者的骨关节炎发病中的作用。方法 应用酶谱分析法研究血清和滑液中金属蛋白酶－2和－9的活性，同时检查有关实验室指标及膝关节X线。实验对象为39例膝骨关节炎患者，对照组包括类风湿关节炎68例、强直性脊柱炎79例和反应性关节炎39例以及正常人14例。结果 在实验组和各关节炎对照组所有血清及滑液标本中金属蛋白酶－9和－2酶原活性均比正常对照组显著增强，骨关节炎滑液中金属蛋白酶－9酶原活性与其活性形式的活性呈正相关（r=0.656,P=0.038）。金属蛋白酶－2酶原及其活性形式与骨关节炎无相关。结论 金属蛋白酶－9酶原及其活性形式可能是反映关节局部炎症的标志物，与骨关节炎关节软骨破坏有关。

Matrix metalloproteinase (MMP)-2 and -9 in serum and synovial fluid in patients with osteoarthritis.

Objective　To clarify the role of MMP-2 and -9 in the pathogenesis of osteoarthritis (OA),the activities of MMP-2 and -9 in serum, synovial fluid (SF) in patients with OA were detected.Methods　Zymography was used to determine the gelatinolytic activities of MMPs in serum and SF from 39 patients with OA,68 rheumatoid arthritis,79 ankylosing spondylitis,39 reactive arthritis,and 14 healthy volunteers.Results　The predominant MMP-9 zymogen (MMP-9z) and MMP-2z activities were evident in all serum and SF samples of all groups,and both significantly higher in each arthritic group compared with the volunteers.MMP-9z activity in OA SF was marginally correlated to SF PMN count(r＝0.406,P＝0.054 8),and higher in grade Ⅱ OA than that in grade Ⅳ (P＜0.05)，PMN count of SF in positive MMP-9 active form (MMP-9a) subgroup was higher than the negative group (t＝2.354,P＝0.038),MMP-2z and MMP-2a were both not markedly correlated with OA variables analyzed.Conclusion　MMP-9z and MMP-9a may be potential markers reflecting arthritic inflammation, and related to degradation of OA cartilage.