金属蛋白酶MMP-3测定对类风湿关节炎与骨性关节炎鉴别诊断的意义

目的探讨基质金属蛋白酶在骨性关节炎(OA)和类风湿性关节炎(RA)损害中的作用.方法采用单克隆抗体酶免疫测定技术检测OA和RA患者血清及关节液中的金属蛋白酶MMP-3的含量,并与正常男女对照组作比较.结果(1)正常对照组男性血清MMP-3含量比女性高1～2倍.(2)OA组血清MMP-3平均水平男性为(141±37)μg/L,对照组为(68±16)μg/L;女性为(110±29)μg/L,对照组为(33±11)μg/L,男女两组与对照组比较差别有统计学意义(P＜0.05或P＜0.01).关节液中的MMP-3的平均浓度为(32970.02±4870.82)μg/L,明显高于血清测定值.(3)在RA组,血清MMP-3水平男性为(681±127)μg/L,女性为(567±116)μg/L显著高于正常对照组及OA病人组(P＜0.01).(4)RA组、OA组血清与关节液中MMP-3水平呈正相关(r分别为0.790 6,0.882 1).结论MMP-3的血清水平RA患者显著高于OA患者,这对于RA和OA的鉴别诊断,探讨发病机理及治疗监测等具有重要的意义.

The Significance of MMP-3 in Serum and Synovial Fluid in the Differential Diagnosis of Rheumatoid Arthritis and Osteoarthritis

Objective:To investigate the effects of matrix metalloproteinases MMP-3in patients with osteoarthritis(OA)or rheumatoid arthritis(RA).Methods:The concentration of MMP-3in serum and synovial fluid(SF)in patients with RA or OA and from healthy control were measured using specific ELISA.Results:(1)In control group,the value of MMP-3in serum was nearly2times higher in males than that in females.(2)The serum MMP-3levels in OA group were significantly higher than that in control group(P<0.05).The MMP-3levels in SF were significantly higher than that in OA group.(3)Levels of MMP-3in RA group were significantly higher than that in OA and control groups(P<0.01).(4)There was a significant correlation between the concentration of MMP-3in SF and serum in patients with RA and OA(r=0.7906,0.8821respectively).Conclusion:Since the serum level of MMP-3in RA was significantly higher than that in OA,it may be a superior indicator in distinguishing RA from OA.Serum levels of MMP-3are useful for monitoring therapy of OA and RA.