论文部分内容阅读
目的:研究类风湿关节炎(RA)患者血清中基质金属蛋白酶3(MMP-3)的水平及其与疾病活动评分、骨侵蚀的相关性。方法:选择常德市第一人民医院2018年7月至2019年12月确诊的RA患者100例为RA组，同期来院体检的健康志愿者35例为对照组，收集患者临床资料，采用酶联免疫吸附法(ELISA)检测RA患者及健康志愿者血清MMP-3水平。比较不同疾病活动评分、不同X线分期、不同骨密度RA患者的血清MMP-3水平，并分析其与临床指标的相关性。结果:⑴RA患者根据28关节疾病活动评分(DAS28)分组，高度活动期组[(300.87±15.93)ng/ml]和中度活动期组[(213.78±12.79)ng/ml]血清MMP-3水平均较临床缓解期组[(82.87±8.19)ng/ml]明显升高。⑵RA患者组血清MMP-3水平[(190.98±13.43)ng/ml]明显高于健康对照组[(69.97±10.63)ng/ml]。⑶不同X线分期RA患者比较，Ⅲ期[(206.18±13.58)ng/ml]、Ⅳ期[(301.72±13.43)ng/ml]的血清MMP-3水平明显高于Ⅰ期[(89.16±10.13)ng/ml]。⑷RA患者根据骨密度分组，骨量减少组[(180.87±12.69)ng/ml]和骨质疏松组[(289.54±13.28)ng/ml]血清MMP-3水平明显高于骨量正常组[(121.05±8.45)ng/ml]，差异有统计学意义(n P<0.05)。⑸RA组患者血清MMP-3水平与CRP、ESR、DAS28评分、类风湿因子(RF)、关节肿胀数、关节压痛数、血小板计数(PLT)呈正相关(n P<0.05)。n 结论:MMP-3在RA的病情进展中起重要作用，且与RA疾病活动度、骨侵蚀、骨质疏松相关，有望成为预测RA骨侵蚀及放射学进展的血清学指标。“,”Objective:To investigate the expression of serum matrix metalloproteinase 3 (MMP-3) in patients with rheumatoid arthritis (RA) and analyze its correlation with bone erosion and disease activity.Methods:100 RA patients diagnosed in the First People's Hospital of Changde from July 2018 to December 2019 were selected as the RA group, and 35 healthy volunteers who came to the hospital for physical examination at the same time were selected as the control group. The clinical data of the patients were collected, and the serum MMP-3 levels of the patients and healthy volunteers were detected by enzyme-linked immunosorbent assay (ELISA). The serum MMP3 levels of RA patients with different disease activity, different imaging stages and different bone mineral density were compared, and the correlation with clinical indicators were analyzed.Results:⑴ RA patients were grouped according to the Disease Activity Score (DAS) 28. Serum MMP-3 levels in the highly active group (300.87±15.93)ng/ml and in the moderately active group (213.78±12.79)ng/ml were higher than those in the clinical remission group (82.87±8.19)ng/ml increased significantly. ⑵ The serum MMP3 level in the RA group (190.98±13.43)ng/ml was significantly higher than that in the healthy control group (69.97±10.63)ng/ml. ⑶ There were significant differences in serum MMP-3 levels among RA patients with different imaging stages (n P<0.05). The level of MMP-3 in stage Ⅲ (206.18±13.58)ng/ml and stage Ⅳ (301.72±13.43)ng/ml were significantly higher than those in stage Ⅰ (89.16±10.13)ng/ml. ⑷ RA patients were divided into normal group, osteopenia group, and osteoporosis group according to bone mineral density. The serum MMP-3 level in the osteopenia group (180.87±12.69)ng/ml and osteoporosis group (289.54±13.28)ng/ml were significantly higher than that in the normal group (121.05±8.45)ng/ml. ⑸ Serum MMP-3 levels were positively correlated with C-reaction (CRP), erythrocyte sedimentation rate (ESR), DSA 28, rheumatoid factor (RF), joint swelling index, joint tenderness index, and platelet count in the RA group (n P<0.05).n Conclusions:The serum MMP-3 plays an important role in the progression of RA, and is closely related to RA disease activity and bone erosion. It is expected to become a serological indicator for predicting RA bone erosion and radiological progress.