早期类风湿性关节炎患者血清Ⅰ型胶原吡啶交联终肽、基质金属酶-3等指标的检测及意义

doi:10.3969/j.issn.1673-8640.2013.05.013

检验医学 ›› 2013, Vol. 28 ›› Issue (5): 400-403.DOI: 10.3969/j.issn.1673-8640.2013.05.013

早期类风湿性关节炎患者血清Ⅰ型胶原吡啶交联终肽、基质金属酶-3等指标的检测及意义

董奕裕

1.浙江省荣军医院检验科，浙江嘉兴 314000；2.浙江省荣军医院中西结合骨伤科，浙江嘉兴 314000；3.浙江省荣军医院放射科，浙江嘉兴 314000；4.浙江省荣军医院风湿免疫科，浙江嘉兴 314000

收稿日期:2012-12-14 修回日期:2013-03-12 出版日期:2013-05-15 发布日期:2013-05-14
通讯作者: 董奕裕
作者简介:董奕裕，男，1968年生，学士，主管技师，主要从事临床免疫学研究。
基金资助:
嘉兴市科技局计划项目(2010AY1053)

Detection and significance of serum cross-linked carboxyterminal telopeptide region of type Ⅰ collagen and matrix metalloproteinase enzyme-3 in patients with early rheumatoid arthritis

1. Department of Clinical Laboratory， Rongjun Hospital of Zhejiang， Zhejiang Jiaxing 314000， China; 2. Department of Integrative Medicine Orthopedics， Rongjun Hospital of Zhejiang， Zhejiang Jiaxing 314000， China; 3. Department of Radiology， Rongjun Hospital of Zhejiang， Zhejiang Jiaxing 314000， China; 4. Department of Rheumatism Immunology， Rongjun Hospital of Zhejiang， Zhejiang Jiaxing 314000， China

Received:2012-12-14 Revised:2013-03-12 Online:2013-05-15 Published:2013-05-14

摘要/Abstract

摘要： 目的　探讨Ⅰ型胶原吡啶交联终肽(ICTP)、基质金属酶-3 (MMP-3) 、抗环瓜氨酸肽(CCP)抗体、类风湿因子(RF)检测及类风湿性关节炎（RA）活动度在RA早期诊断中的意义。方法　应用酶联免疫吸附试验（ELISA）检测213例RA患者（早期RA组92例、中长期RA组121例）、43例非RA的其他免疫系统疾病患者和40名正常对照者血清ICTP、MMP-3及抗CCP抗体；同时采用免疫比浊法检测血清RF。结果　 ICTP、MMP-3、抗-CCP抗体、RF在早期RA诊断中的最佳临界值分别为3.21 μg/L、67.45 ng/mL、15.45 U/mL、12.35 U/mL，灵敏度分别为74.0%、63.4%、52.4%、55.3%，特异性为95.5%、81.8%、95.5%、90.9%。RA各组RF、抗CCP水平均高于对照组及非RA组(P＜0.01)，ICTP、MMP-3、RF在非RA组和正常对照组间差异有统计学意义（P＜0.01），ICTP在早期RA与非RA组间差异无统计学意义（P＞0.05）。X线分期中Ⅰ期患者的ICTP、MMP-3、抗CCP抗体及RF水平与Ⅱ、Ⅲ期、Ⅳ期患者比较差异均有统计学意义(P＜0.05、P＜0.01)。Ⅱ期患者ICTP、MMP-3及抗CCP抗体水平与Ⅲ、Ⅳ期比较差异均有统计学意义（P＜0.05、P＜0.01），而RF水平3组之间差异无统计学意义 (P＞0.05)。结论　同时检测ICTP、MMP-3、抗CCP抗体和RF能提高RA早期诊断的准确性，减少漏诊，动态联合检测可有效监测RA病情进展。

关键词: Ⅰ型胶原吡啶交联终肽, 基质金属酶-3, 抗环瓜氨酸肽抗体, 类风湿因子, 类风湿性关节炎

Abstract: Objective　To investigate the significance of cross-linked carboxyterminal telopeptide region of type Ⅰ collagen (ICTP)， matrix metalloproteinase-3 (MMP-3)， anti-cyclic citrullinated peptide (CCP) antibody， rheumatoid factor (RF) and rheumatoid arthritis(RA) activity in the early diagnosis of RA. Methods　The enzyme-linked immunosorbent assay(ELISA) was used to determine the serum samples of 213 patients with RA (early RA group: 92 cases and medium-and long-term RA group: 121 cases)， 43 patients with non-RA associated and immune diseases and 40 healthy controls. The serum ICTP， MMP-3 and anti-CCP antibody were determined. The serum RF was determined by immunoturbidimetry. Results　The optimal cut-off values of ICTP， MMP-3 and anti-CCP antibody in the diagnosis of early RA were 3.21 μg/L， 67.45 ng/mL， 15.45 U/mL and 12.35 U/mL. The sensitivities were 74.0%，63.4%，52.4% and 55.3%， and the specificities were 95.5%， 81.8%， 95.5% and 90.9%. RF and anti-CCP antibody were higher in the RA group than in the healthy control group and the non-RA group (P＜0.01). ICTP， MMP-3 and RF in the non-RA group and the healthy control group had statistical significance ( P＜0.01). ICTP in early RA and non-RA group had no statistical significance (P＞0.05). The ICTP， MMP-3， anti-CCP antibody and RF of X ray staging Phase Ⅰ had statistical significances with those staging Phase Ⅱ， Ⅲ and Ⅳ(P＜0.05， P＜0.01). The ICTP， MMP-3 and anti-CCP antibody of Phase Ⅱ with those of Phase Ⅲ and Ⅳ had statistical significance (P＜0.05， P＜0.01). The RF among Phase Ⅱ， Ⅲ and Ⅳ had no statistical significance (P＞0.05). Conclusions　The simultaneous detection of ICTP， MMP-3， anti-CCP antibody and RF can improve accuracy and reduce missed diagnosis. Dynamic combination detection can monitor effectively the progression of RA.

Key words: Cross-linked carboxyterminal telopeptide region of type Ⅰ collagen, Matrix metalloproteinase-3, Anti-cyclic citrullinated peptide antibody, Rheumatoid factor, Rheumatoid arthritis

董奕裕1，张新根2，陆建良3，于国芳4，陆鑫丽1. 早期类风湿性关节炎患者血清Ⅰ型胶原吡啶交联终肽、基质金属酶-3等指标的检测及意义[J]. 检验医学, 2013, 28(5): 400-403.

DONG Yiyu 1，ZHANG Xingen 2，LU Jianliang 3，YU Guofang 4，LU Xinli 1. Detection and significance of serum cross-linked carboxyterminal telopeptide region of type Ⅰ collagen and matrix metalloproteinase enzyme-3 in patients with early rheumatoid arthritis[J]. , 2013, 28(5): 400-403.

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早期类风湿性关节炎患者血清Ⅰ型胶原吡啶交联终肽、基质金属酶-3等指标的检测及意义

Detection and significance of serum cross-linked carboxyterminal telopeptide region of type Ⅰ collagen and matrix metalloproteinase enzyme-3 in patients with early rheumatoid arthritis

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