基质金属蛋白酶3在类风湿关节炎患者中的临床意义

目的探讨基质金属蛋白酶3(MMP-3)水平在类风湿关节炎(RA)患者中的临床价值。方法选取2018年1月至2020年1月无锡市第九人民医院收治的74例RA患者为RA组,74例骨关节炎(OA)患者为OA组,另选择同期148例体检健康者为对照组。检测并比较3组红细胞沉降率(ESR)及血清C反应蛋白(CRP)、类风湿因子(RF)及MMP-3水平。采用Pearson相关分析RA组MMP-3水平与ESR、CRP、RF、28关节疾病活动度评分(DAS28)、28个关节肿胀关节数、28个关节压痛关节数、滑膜炎评分、骨髓水肿评分以及骨侵蚀评分相关性。根据RA患者DAS28、骨密度、是否器官/组织受累以及病程分为不同亚组,比较不同亚组间的MMP-3水平。采用受试者工作特征(ROC)曲线分析MMP-3在诊断RA中的临床价值。结果相较于OA组及对照组,RA组ESR及血清CRP、RF、MMP-3水平更高(P<0.05)。相较于OA组,RA组DAS28、28个关节肿胀关节数、28个关节压痛关节数、滑膜炎评分、骨髓水肿评分以及骨侵蚀评分更高(P<0.05)。相关性分析结果显示,RA组MMP-3水平与ESR、CRP、RF、DAS28、28个关节肿胀关节、28个关节压痛关节、滑膜炎评分、骨髓水肿评分以及骨侵蚀评分均呈正相关(P<0.05)。不同亚组间比较结果显示,关节疾病活动度高、骨质疏松、存在器官/组织受累、病程<1年及疾病活动期患者MMP-3水平更高(P<0.05)。ROC曲线结果显示,MMP-3诊断RA的曲线下面积为0.826,最佳临界值为41.77 ng/mL。结论RA患者血清MMP-3水平显著上升,其水平升高在诊断RA中具有一定临床价值。

Clinical significance of matrix metalloproteinase-3 in patients with rheumatoid arthritis

Objective To investigate the clinical value of matrix metalloproteinase-3(MMP-3)in patients with rheumatoid arthritis(RA).Methods A total of 74 RA patients admitted to Wuxi Ninth People′s Hospital from January 2018 to January 2020 were selected as the RA group,74 patients with osteoarthritis(OA)were selected as the OA group,and 148 healthy persons with physical examination during the same period were selected as the control group.The erythrocyte sedimentation rate(ESR)and the serum levels of C-reactive protein(CRP),rheumatoid factor(RF)and MMP-3 in the three groups were measured and compared.Pearson correlation was used to analyze the correlation between MMP-3 level and ESR,CRP,RF,28 joint disease activity score(DAS28),28 joint swelling joints,28 joint tenderness joints,synovitis score,bone marrow edema score and bone erosion score in RA group.Patients with RA were divided into different subgroups according to DAS28,bone mineral density,organ/tissue involvement and course of disease,and the MMP-3 levels among different subgroups were compared.The receiver operating characteristic(ROC)curve was used to analyze the clinical value of MMP-3 in the diagnosis of RA.Results Compared with the OA group and the control group,ESR and the serum levels of CRP,RF and MMP-3 in the RA group were higher(P<0.05).Compared with the OA group,DAS28,28 swollen joints,28 tender joints,synovitis score,bone marrow edema score and bone erosion score in RA group were higher(P<0.05).Correlation analysis results showed that the level of MMP-3 in the RA group was positively correlated with ESR,CRP,RF,DAS28 scores,28 joint swelling joints,28 joint tenderness joints,synovitis score,bone marrow edema score,and bone erosion score(P<0.05).The comparison results among different subgroups showed that patients with high joint disease activity,osteoporosis,organ/tissue involvement,and disease duration<1 year and disease active period had higher levels of MMP-3(P<0.05).Compared with the disease remission group,patients in the disease activity group had higher levels of MMP-3(P<0.05).ROC curve showed that the area under the curve of MMP-3 in the diagnosis of RA was 0.826,and the best critical value was 41.77 ng/mL.Conclusion The level of serum MMP-3 in patients with RA increased significantly,which has a certain clinical value in the diagnosis of RA.