强直性脊柱炎患者血清基质金属蛋白酶-3水平及意义

摘要

Objective To investigate the level of serum matrix metalloproteinase-3 (MMP-3) and its significance in patients with ankylosing spondylitis (AS).Methods The serum MMP-3 level in 175 AS patients who were not on slow-acting antirheumatics or glucocorticoids within the previous 6 months and in 95 healthy normal controls was determined with enzyme linked immunosorbent assay (ELISA).At the same time, laboratory parameters such as erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), Interleukin-6 (IL-6), Tumor necrosis factor-α (TNF- α) and sacroiliac joint X-ray were investigated, and analyzed for their correlation with the level of serum MMP-3.Results The serum MMP-3 level was significantly higher in AS patients [(226±169) ng/ml]as compared with normal controls [(53±21) ng/ml](P＜0.05).There was no significant difference in serum MMP-3 level among the AS patients with different clinical features (P＞0.05).The MMP-3 level was positively correlated with ESR, CRP, BASDAI score, IL-6 and TNF-α levels, but not with age of onset, duration of disease, length of morning stiffness and X-ray grading (P＞0.05).Conclusion The highly elevated level of serum MMP-3 in the AS patients can favorably reflect both joint damage and the disease activity, and can be used as a serologic marker for the progression or improvement of AS independently of ESR and CRP.%目的 探讨强直性脊柱炎(AS)患者血清基质金属蛋白酶-3(MMP-3)的水平及意义,为临床治疗、判断预后提供新的理论依据.方法 采用酶联免疫吸附实验(ELISA)测定175例AS患者(就诊前6个月内未用过慢作用药及糖皮质激素)和95名健康对照者血清MMP-3的水平,同时测定其治疗前的其他实验室指标:红细胞沉降率(ESR)、C反应蛋白(CRP)、白细胞介素6(IL-6)、肿瘤坏死因子α(TNF-a)、骶髂关节X线.分析它们与MMP-3的相关性.结果 AS患者血清MMP-3水平[(226±169)ng/ml]明显高于健康对照组[(53±21)ng/ml],P0.05);MMP-3水平与AS患者的ESR、C反应蛋白(CRP)、患者血清CRP、BASDAI评分、白细胞介素6(IL-6)、TNF-α呈正相关(P<0.05);而与发病年龄、病程、晨僵时间、X线分级无明显关系(P<0.05).结论 MMP-3在AS患者血清中高水平存在.它既能够反映AS关节骨质破坏,又能更好地反映疾病活动程度,可作为除ESR、CRP外提示As疾病进展与改善的血清学指标.