混合性结缔组织病患者抗-U1RNP及血清MMP-3和MMP-9含量变化的相关性研究

目的探讨混合性结缔组织病（MCTD）患者血清MMP-3及MMP-9的水平及意义及抗一UIRNP相关性，为临床治疗、判断预后提供新的理论依据。方法采用双抗体夹心法ELISA测定89例MCTD患者（就诊前6个月内未用过免疫抑制剂及糖皮质激素）和65例正常健康对照者血清MMP-3及MMP-9的水平，并选取部分患者进行治疗后的MMP-3测定，比较不同时期MMP-3的水平。同时采用免疫斑点法测定U1RNP抗体并测定其治疗前的其它实验室指标：ESR、CRP、血清球蛋白。结果MCTD患者血清MMP-3及MMP-9水平分别是（235．62±158．51）ng／ml和（168．25±10．91）明显高于正常对照组（62．72±25．41）（32．04±4．68）ng／ml。P〈0．001；40例患者治疗后1年血清MMP-3及MMP-9明显降低，差异有统计学意义（P=0．0015）。MMP-3及MMP-9水平与MCTD患者的ESR、CRP血清球蛋白、U1RNP抗体呈正相关（P〈0．05）；而与发病年龄、痛程无明显关系（P〉0．05）。结论MMP-3、MMP-9在MCTD患者血清中高水平存在并与U1RNP抗体的滴度有明显相关性；能更好的反映MCTD疾病活动程度，可作为除ESR、CRP以外提示MCTD痰病进展与改善的血清学指标；长期正规治疗能显著降低血清MMP-3、MMP-9的水平。

The relativity study of anti-U1RNP,MMP-3 and MMP-9 in patients with mixed connective tissue disease

Objective To investigate the significance and serum level of MMP- 3 and MMP - 9 in patients with mixed connective tissue disease（MCTD） ,which may provide new method for judgement of prognosis and therapy effect. Method MMP - 3 and MMP - 9 was tested by ELISA in 65 healthy controls and 89 patients with MCTD before and after treament. ESR, CRP, U1RNP and Globulin were examined at the same time. Result Compared to healthy controls, the serum level of MMP - 3 and MMP - 9 was Significantly higher in patients with MACD（P 〈 0.001）, Serum level of MMP - 3 and MMP - 9 after treatment for 1 years was lower than that before treatment（P = 0.001）. MMP - 3 and MMP - 9 level was positively correlated with ESR,CRP, ESR,CRP,U1RNP and Globulin level,but had no obvious corelation with age of onset and the disease course. Conclusion The present results suggested that the level of MMP - 3 and MMP - 9 was higher in patients with MCTD. The level of MMP - 3 and MMP - 9 may better reflect the disease activity than ESR and CRP and significantly decreased after long - term regular treatment. So we can choose MMP - 3 and MMP - 9 as a potentially useful laboratory marker of progression and change in patients with MCTD.