髋或膝关节炎患者血清组织蛋白酶D 和α-1 抗胰蛋白酶活性水平

目的：检测髋、膝关节炎患者血清中组织蛋白酶D(cathepsin D，CAT-D)及α-1抗胰蛋白酶(alpha-1antitrypsin，AAT)的活性，以探索这两种酶可否作为检测软骨退行性变的血清生化指标。方法：收集晚期髋或膝关节炎患者(病例组)70例；健康对照组100人。分别运用ELISA法检测病例组术前、行关节置换术后10 d及对照组血清中CAT-D和AAT活性，对2组数据进行比较。结果：与对照组相比，病例组患者术前血清中CAT-D活性降低了25%(P<0.05)，术后10 d血清中CAT-D活性进一步下降50%以上(P<0.05)；术前血清AAT活性无差异(P>0.05)，术后增高了约80%(P<0.05)。两种酶活性在髋与膝关节炎之间比较亦无差异(P>0.05)。性别、高血压、糖尿病等对CAT-D和AAT的活性无影响(P>0.05)。两种酶亦没表现出与年龄的相关性。结论：AAT可能是骨关节炎进展过程中一个炎症因子。CAT-D和AAT不受性别、年龄、是否合并高血压及糖尿病等影响，有希望成为检测软骨退行性变过程的血清生化指标。

Activity of cathepsin D and alpha-1 antitrypsin in patients with hip or knee osteoarthritis

Objective: To assess the activity of cathepsin D (CAT-D) and alpha-1 antitrypsin (AAT) in bloodin patients with hip or knee osteoarthritis, and to explore whether these two enzymes could beserved as serum biomarkers for cartilage degeneration.Methods: The activity of CAT-D and AAT in blood serum of 44 women and 26 men with hip orknee osteoarthritis was determined by the method of ELISA before total joint replacement and onthe 10th day after the surgery. One hundred healthy volunteers were chosen as the control. All datawere analyzed by using SPSS19.0 software.Results: Compared with the controls, the activity of CAT-D in patients with osteoarthritis wasdecreased by 25% (P<0.05) and 50% (P<0.05) before and after the surgery, respectively. The activityof AAT in the osteoarthritis patients before the surgery was not significantly changed compared withthe control group (P>0.05), but it was increased by 80% after the surgery than that in the controlgroup (P<0.05). There was no significant difference in the activities of 2 enzymes between hip andknee osteoarthritis (P>0.05). The gender, hypertension, diabetes and age did not affect the activitiesof the 2 enzymes (P>0.05).Conclusion: AAT might be a possible inflammatory indicator in the osteoarthritis. CAT-D andAAT enzymes are not affected by gender, age, hypertension and diabetes, etc, and they might beserved as potential biomarkers for cartilage degradation.