摘要
目的探讨基质金属蛋白酶-3(MMP-3)与抗环瓜氨酸肽抗体(ACPA)联合应用在类风湿关节炎(RA)疾病诊疗中的临床意义。方法选取2017年12月至2019年5月收治的60例RA患者,根据28个关节疾病活动度评分(DAS28评分)分为稳定组(14例)、低活动组(15例)、中活动组(15例)、高活动组(16例),另选取同期收治40例非RA自身免疫病患者作为疾病对照组,40例健康体检者作为健康对照组。抽血检测所有研究对象血清MMP-3、ACPA水平。采用受试者工作特征曲线(ROC曲线)分析联合检测MMP-3、ACPA对RA的诊断价值,并采用Spearman相关分析MMP-3、ACPA与RA患者疾病活动度关系。结果血清MMP-3、ACPA水平RA组>疾病对照组>健康对照组(P<0.05);血清MMP-3、ACPA水平高活动度组>中活动度组>低活动度组>稳定组(P<0.05);ROC曲线显示,MMP-3、ACPA对RA具有一定诊断价值(AUC=0.770、0.781,P<0.01),且联合检测(AUC=0.891,P<0.01)诊断价值较高;Spearman相关分析,血清MMP-3、ACPA水平与RA患者疾病活动度均呈显著正相关(r=0.689、0.837,P<0.01)。结论MMP-3、ACPA可作为RA早期诊断实验室指标,两者联合检测时可提高对RA诊断准确率;此外,两者均与RA患者疾病活动度有关,可为临床用药提供指导。
Objective To explore the clinical significance of matrix metalloproteinase-3(MMP-3)and anti-cyclic citrullinated peptide antibody(CCP)in rheumatoid arthritis(RA)disease.Methods A total of 60 RA patients admitted from December,2017 to May,2019 were selected and divided into the stable group(14 cases),low-activity group(15 cases),and medium-activity group(15 cases),high activity group(16 cases),while 40 cases of non-RA autoimmune disease patients admitted during the same period were selected as the disease control group,and 40 healthy physical examination subjects were selected as the healthy control group.Blood was drawn to detect serum MMP-3 and CCP levels in all study subjects.Receiver operating characteristic curve(ROC curve)was used to analyze the diagnostic value of combined detection of MMP-3 and CCP for RA,and the Spearman correlation was used to analyze the relationship between MMP-3,CCP and disease activity in RA patients.Results Serum MMP-3 and CCP levels in RA group>disease control group>healthy control group(P<0.05).Serum MMP-3 and CCP levels in high activity group>medium activity group>low activity group>stable group(P<0.05);ROC curve showed that MMP-3 and CCP had a certain diagnostic value for RA(AUC=0.770,0.781,P<0.01),and combined detection(AUC=0.891,P<0.01)had a higher diagnostic value;Spearman correlation analysis showed serum MMP-3 and CCP levels were significantly positively correlated with disease activity in RA patients(r=0.689,0.837,P<0.01).Conclusion MMP-3 and CCP can be used as laboratory indicators for the early diagnosis of RA.When the two indexes are jointly detected,the accuracy of the diagnosis of RA can be improved;In addition,both markers are related to the disease activity of RA patients and can provide guidance for clinical medication.
作者
王璐
李汉华
翁文浩
张敏
赵美芸
蔡惠萍
陆天宇
WANG Lu;LI Hanhua;WENG Wenhao;ZHANG Min;ZHAO Meiyun;CAI Huiping;LU Tianyu(Department of Clinical Laboratory,Affiliated Yangpu Hospital.School of Medicine,Tongji University,Shanghai 200090,China)
出处
《标记免疫分析与临床》
CAS
2022年第4期580-583,594,共5页
Labeled Immunoassays and Clinical Medicine
基金
老年病相关生化诊断试剂量值溯源及质量评价研究(编号:2019YFF0216502)。
