摘要
目的 评价血清基质金属蛋白酶（sMMP）-3评估类风湿关节炎（RA）患者病情活动的真实性.方法 通过ELISA法,检测2010年6月至2014年6月中山大学孙逸仙纪念医院风湿科门诊及住院的RA患者191例及性别年龄匹配的58例健康人的sMMP-3.收集RA患者临床资料,应用ROC曲线制定最佳评估界限值并分析sMMP-3评估RA病情活动的真实性指标.结果 191例RA患者中女128例,男63例,男女RA患者sMMP-3水平分别高于相应正常对照组（均P＜0.01）,活动期显著高于缓解期（均P＜0.01）.sMMP-3评估女性或男性RA病情活动的ROC曲线下面积（AUC）分别为0.822和0.824（均P＜0.01）,最佳评估界限值为84 μg/L和168 μg/L.根据最佳评估界限值,sMMP-3联合CRP评估RA病情活动的敏感度（97.2％）显著高于单独检测sMMP-3（84.7％）或CRP（88.2％）,均P＜0.05,特异度（95.7％）显著高于单独检测sMMP-3（68.1％,P＜0.01）,正确指数（0.951）高于单独检测sMMP-3（0.528）和CRP （0.754）.结论 sMMP-3可用于评估RA患者病情活动,应用sMMP-3最佳评估界限值及联合CRP可提高评估的真实性。
Objective To investigate the value of serum matrix metalloproteinase-3 （sMMP-3） in the assessment of active disease in patients with rheumatoid arthritis （RA）.Methods One hundred and ninety-one RA patients were recruited from the Department of Rheumatology of Sun Yat-sen Memorial Hospital from June 2010 to June 2014.sMMP-3 level of these RA patients and 58 healthy people was tested by enzyme-linked immunosorbent assay,while clinical data was collected simultaneously.Receiver operating characteristic （ROC） curve was used for the analysis of optimal cut-off point for the evaluation of disease activity.Results There were 128 female patients and 63 male patients recruited.sMMP-3 was significantly higher in RA patients than healthy control and it was higher in patients with active disease than that in patients in remission （all P 〈 0.01）.ROC curve analysis showed that the optimal cut-off point for diagnosing active RA was 84 μg/L with area under the curve （AUC） 0.822 in female and 168 μg/L with AUC 0.824 in male （both P 〈0.01）.According to the optimal cut-off points,the sensitivity of sMMP-3 ＋ CRP combined detection was 97.2% for diagnosing active RA,which was significantly higher than that of sMMP-3 （84.7%） or C-reactive protein （CRP） （88.2%,both P 〈 0.05）.The specificity of combined detection was 95.7%,which was significantly higher than that of sMMP-3 （68.1%,P 〈0.01）.And Youden＇s index of combined detection （0.951） was significantly higher than that of sMMP-3 （0.528） or CRP （0.754,both P 〈 0.05）.Conclusion sMMP-3 is a helpful indicator for disease activity measurement in RA patients.Combined detection of sMMP-3 and CRP can improve the accuracy of disease activity assessment.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2015年第47期3823-3828,共6页
National Medical Journal of China
基金
国家自然科学基金（81471597）
高等学校博士学科点专项科研基金（20130171110075）
广东省自然科学基金（2014A030313074）
