摘要
目的探讨幼年特发性关节炎（JIA）多关节型患儿血清及关节液基质金属蛋白酶（MMP）-1、MMP-3、金属蛋白酶抑制剂（TIMP）-1、白细胞介素（IL）-1、肿瘤坏死因子（TNF）-α，转化生长因子（TGF）-β水平的变化及临床意义。方法酶联免疫吸附试验（ELISA）检测32例多关节型JIA患儿及28例对照组（外伤性关节炎患儿）血清及关节液中MMP-1、MMP-3、TIMP-1、IL-1、TNF-α、TGF-β的水平。同时检测血白细胞计数、C反应蛋白（CRP）、红细胞沉降率（ESR）及类风湿因子（RF）水平。统计学方法采用两个独立样本的t检验及Pearson直线相关分析。结果①JIA组血清MMP-1、MMP-3、IL-1、TNF—α水平分别为（158±67）ng／ml、（212±89）n咖l、（39±19）pg/ml、（26±10）pg／ml，明显高于对照组（P均〈0．05），MMP-3／TIMP-1为0．86±0．32，亦较对照组升高（P〈0．05），TIMP-1、TGF-β水平分别为（248±88）、（17±9）ng／ml，明显低于对照组（P均〈0．05）；血清MMP-3、MMP-3／TIMP-1与白细胞计数、CRP、ESR呈正相关（JP均〈0．05）。②JIA组关节液MMP-1、MMP-3、IL-1、TNF-α水平分别为（216±78）ng/m1、（766±291）ng／ml、（56±21）pg／ml、（36±14）pg／ml，明显高于对照组（P均〈0．05），MMP-3／TIMP-1为2．68±0．89，亦较对照组明显升高（P〈0．05），TIMP-1、TGF—β水平分别为（286±88）、（12±4）ng／ml，明显低于对照组（P均〈0．05）。③JIA组关节液MMP-1、MMP-3、TIMP-1、IL-1、TNF-α水平明显高于其血清水平（P均〈0．05），TGF．B水平则明显低于其血清水平（P〈0．05）。结论血清及关节液中MMP-1、MMP-3、IL-1、TNF—d水平升高，TIMP-1水平降低，参与了JIA多关节型的发病过程，TGF-β水平降低，在其发病中可能起保护作用。血清MMP-3/TIMP-1比值与JIA炎性指标呈正相关，有助于判断病情活动性。
Objective The purpose of the study was to investigate the changes and clinical signific- ance of matrix metalloproteinase （MMP）-1, MMP-3, tissue inhibitor of metalloproteinase （TIMP）, interleukin （IL）-1, tuhmr necrosis factor （TNF）-α and transforming growth factor（TGF）-β in juvenile idiopathic arthritis （JIA）. Methods Thirty-two JIA subjects and 28 controls （traumatic arthritis patients） were included into this study. The MMP-1, MMP-3, TIMP, IL-1, TNF-α and TGF-β level in the serum and synovia were assessed by ELISA. The WBC count, the level of CRP, ESR, RF were also detected. Independent t-test and Pearson＇s analysis were adopted for data analysis. Results ① The level of MMP-1, MMP-3, IL-1 and TNF-α in the serum was （158±67） ng/ml, （212±89） ng/ml, （39±19） pg/ml, （26±10） pg/ml respectively, which was significantly higher than that of the control group （all P〈O.05）; the ratio of MMP-3/TIMP-1 （0.86±0.32） was higher in the study group than that of the control group （P〈0.05）,while the value of TIMP-1, TGF-β was （248±88）, （17±9） ng/ml respectively, which was lower than that of the＇control group （P〈0.05）. The value of seral MMP-3, MMP-3/TIMP-1 was positively correlated with that of WBC, CRP, ESR in the JIA group （all P〈0.05）. ② The value of MMP-1, MMP-3, IL-1 and TNF-α in the synovia was （216±78） ng/ml, （766±291） ng/ml, （56±21） pg/ml, （36±14） pg/ml respectively, which was higher than that of the control group （all P〈0.05）; the ratio of MMP-3/TIMP-1 （2.68±0.89） was higher than that of the control group （P〈0.05）, while the value of TIMP-1, TGF-β was （286±88） ng/ml, （12±4） ng/ml respectively, which was lower than that of the control group （all P〈0.05）. ③ The value of MMP-1, MMP-3, TIMP-1, IL-1 and TNF-α in the synovia was higher than that in the serum （all P〈0.05）, while the value of TGF-β was lower than that in the serum （P〈0.05）. Conclusion The value of MMP-1, MMP-3, IL-I and TNF-α increases both in the serum and synovia, while the value of TIMP-1 decreases. The value of TGF-β decreases, which may have protective effect on JIA. The ratio of MMP-3/FIMP-1 in the serum is positively correlated to inflammation parameters, which may be used to judge the activity of illness in JIA.
出处
《中华风湿病学杂志》
CAS
CSCD
北大核心
2013年第9期601-605,共5页
Chinese Journal of Rheumatology
基金
武汉市卫生局临床重点专科研究项目（武卫[2007]43号）
