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正常血清基质金属蛋白酶-3 水平可用于预测类风湿关节炎患者的临床缓解和正常身体功能。

Normal serum matrix metalloproteinase-3 levels can be used to predict clinical remission and normal physical function in patients with rheumatoid arthritis.

机构信息

National Hospital Organization Nagoya Medical Center, Orthopaedic Surgery and Rheumatology, 4-1-1 Sannomaru, Naka-ku, Nagoya, Aichi, 460-0001, Japan.

出版信息

Clin Rheumatol. 2019 Jan;38(1):181-187. doi: 10.1007/s10067-017-3829-9. Epub 2017 Sep 22.

Abstract

This study aimed to evaluate whether normal serum matrix metalloproteinase-3 (MMP-3) levels can be used to predict clinical remission and normal physical function at a single time point when treating patients with rheumatoid arthritis (RA) in daily practice settings. Subjects were all 1321 RA patients who were treated at our hospital. The accuracy of serum MMP-3 levels was larger than those of C-reactive protein (CRP) levels for predicting clinical remission [Simplified Disease Activity Index (SDAI) ≤ 3.3], normal function [Disability Index of the Health Assessment Questionnaire (HAQ-DI) ≤ 0.5], and both in clinical remission and with normal function (clinical remission + normal function) using receiver operating characteristic curve analysis. Serum MMP-3 levels were significantly correlated with CRP levels [r 0.229 (men), r 0.476 (women)] using Pearson's correlation coefficients. Among patients with normal CRP levels (n = 807), the percentage of patients in clinical remission, with normal function, and with clinical remission + normal function having normal serum MMP-3 levels was significantly higher than those with abnormal serum MMP-3 levels. In addition, among patients with the 28-point count Disease Activity Score-CRP (DAS28-CRP) remission (DAS28-CRP < 2.3), the percentage of patients in clinical remission, with normal function, and with clinical remission + normal function having normal serum MMP-3 levels was significantly higher than those with abnormal serum MMP-3 levels. Our findings suggest that normal serum MMP-3 levels, in combination with CRP levels or disease activity, are useful for predicting clinical remission and normal physical function in patients with RA.

摘要

本研究旨在评估在日常实践环境中治疗类风湿关节炎 (RA) 患者时,正常血清基质金属蛋白酶-3 (MMP-3) 水平是否可用于预测单一时间点的临床缓解和正常身体功能。研究对象均为在我院接受治疗的 1321 例 RA 患者。血清 MMP-3 水平对预测临床缓解[简化疾病活动指数 (SDAI) ≤ 3.3]、正常功能[健康评估问卷残疾指数 (HAQ-DI) ≤ 0.5]以及临床缓解和正常功能兼具的准确性均大于 C 反应蛋白 (CRP) 水平,这通过受试者工作特征曲线分析得出。使用 Pearson 相关系数分析,血清 MMP-3 水平与 CRP 水平呈显著相关[r0.229(男性),r0.476(女性)]。在 CRP 水平正常(n=807)的患者中,具有正常血清 MMP-3 水平的患者在临床缓解、功能正常以及兼具临床缓解和正常功能的比例明显高于具有异常血清 MMP-3 水平的患者。此外,在 CRP 正常的 28 个关节疾病活动度评分 (DAS28-CRP) 缓解患者(DAS28-CRP < 2.3)中,具有正常血清 MMP-3 水平的患者在临床缓解、功能正常以及兼具临床缓解和正常功能的比例明显高于具有异常血清 MMP-3 水平的患者。我们的研究结果表明,正常血清 MMP-3 水平结合 CRP 水平或疾病活动度,有助于预测 RA 患者的临床缓解和正常身体功能。

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