英夫利昔单抗治疗类风湿关节炎对外周血CD147及MMPs的影响

目的探讨Infliximab对类风湿关节炎患者外周血CD147及MMPs的影响。方法选择类风湿关节炎患者40例为研究对象,所有患者均经MTX治疗3个月但效果欠佳。其中20例患者加用Infliximab治疗14周,为第一组;10例患者加用Infliximab治疗6周,为第二组;10例患者继续给予MTX治疗14周,为第三组。分别于第0、10、18周检测患者外周血单个核细胞CD147和MMPs水平,外周血CD14+细胞CD147的平均荧光强度,第0、18周检测外周血清MMP2、MMP3、MMP9的表达情况。另选择10例健康体检者为对照组。结果第一组晨僵、ERS、CRP、RF、HAQ均有不同程度的下降(P<0.05或0.01),第二组晨僵、ERS、HAQ均有不同程度的下降(P<0.01),但第三组各指标前后变化不明显。治疗后第一组和第二组CD147、MMP9表达均较治疗前下降,而第三组较治疗前增加,三组比较差异有统计学意义(P<0.05),第一组和第二组之间比较差异不明显。MMP2和MMP3三组比较差异不明显。第一组的MMP2、MMP3、MMP9均较前明显下降(P<0.01),第二组MMP3、MMP9均较前明显下降(P<0.01)。第三组各指标差异不明显(P>0.05)。结论 Infliximab联合甲氨蝶呤治疗类风湿关节炎,可以下调外周血中CD147、MMPs的表达,从而改善症状、延缓疾病的进一步发展。

Effect of infliximab on peripheral blood levels of CD147 and MMPs of rheumatoid arthritis

Objective To discuss effect of infliximab on peripheral blood level of CD147 and MMPs of rheumatoid arthritis. Methods Selected 40 cases with RA treated by MTX for 3 months without clinical effect. 20 casses added in- fliximab for 12 weeks and 10 cases for 6 cases, 10 cases continued to be treated by MTX for 6 weeks. Peripheral blood level of CD147, MMPs, Mean fluorescence intensit were detected at 0, 10, 18 weeks. MMP2, MMP3, MMP9 ex- pression were detected at 0, 18 weeks. 10 healthy people were selected as control group. Results Morning stiffness, ERS, CRP, RF, HAQ of the first group decreased （P 〈 0.05 or 0.01 ）. Morning stiffness, ERS, HAQ of the second group decreased （P 〈 0.05 or 0.01 ）. The third group decreased unobvious. CD147, MMP9 of the first group and the second group decreased after therapy than before therapy, and the third group increased. There were significant difference in three groups （P 〈 0.05）. And there was no difference between the first group and the second group. MMP2, MMP3, MMP9 of the first group decreased apparently（P 〈 0.01 ）. MMP2 and MMP3 of the second group decreased apparently （P 〈 0.01 ）, but which of the third group didn＇t decreased （P 〉 0.05）. Conclusion Infliximab combined MTX for RA can decrease expression of CD147, MMPs, improve symptom, delay the disease further development.