抗环瓜氨酸肽抗体与基质金属蛋白酶-3联合检测在类风湿关节炎患者中的诊断价值及与疾病活动度的相关性
Diagnostic value of combined detection of anti-cyclic citrullinated peptide antibody and matrix metalloproteinase-3 in patients with rheumatoid arthritis and its correlation with disease activity
郭靖 1朱玉彬 1王斌2
作者信息
- 1. 淮南新华医疗集团新华医院血液风湿免疫科 安徽 淮南 232052
- 2. 安徽理工大学第一附属医院(淮南市第一人民医院)风湿免疫科 安徽 淮南 232007
- 折叠
摘要
目的 研究抗环瓜氨酸肽(anti-CCP)抗体与基质金属蛋白酶-3(MMP-3)联合检测在类风湿关节炎(RA)患者中的诊断价值及与疾病活动度的相关性.方法 回顾性选取2021年1月至2023年1月入淮南新华医疗集团新华医院的92例RA患者作为RA组.同时,选取同一时期入院的92例非RA自身免疫病患者与92名体检健康者分别作为非RA组、对照组.参考28个关节疾病活动度评分(DAS28)将RA组划分为4个亚组:高活动组(DAS28＞5.1分,n=23)、中活动组(3.2＜DAS28＜5.1 分,n=23)、低活动组(2.6＜DAS28＜3.2 分,n=23)和稳定组(DAS28＜2.6分,n=23).比较RA组、非RA组、对照组研究对象的血清anti-CCP抗体、MMP-3水平和不同关节疾病活动度RA患者的血清anti-CCP抗体、MMP-3水平,通过受试者工作特征(ROC)曲线分析anti-CCP抗体联合MMP-3检测在RA中的诊断价值,并通过Spearman相关分析法分析血清anti-CCP抗体、MMP-3水平与RA患者疾病活动度的相关性.结果 RA组、非RA组的血清anti-CCP抗体、MMP-3水平均明显高于对照组,RA组的血清anti-CCP抗体、MMP-3水平均明显高于非RA组,差异均有统计学意义(P＜0.05).高活动组患者的血清anti-CCP抗体、MMP-3水平明显高于稳定组、低活动度组、中活动度组,中活动度组患者的血清anti-CCP抗体、MMP-3水平均高于稳定组、低活动度组,低活动度组患者的血清anti-CCP抗体、MMP-3水平均高于稳定组,差异均有统计学意义(P＜0.05).ROC曲线显示,单一 anti-CCP抗体诊断RA的ROC曲线下面积(AUC)、敏感度、特异度依次为0.780、0.499、0.945,单一 MMP-3诊断RA的AUC、敏感度、特异度依次为0.769、0.749、0.949,anti-CCP抗体联合MMP-3诊断RA的AUC、敏感度、特异度依次为0.890、0.882、0.962.Spearman相关分析显示,血清anti-CCP抗体、MMP-3水平与RA患者疾病活动度呈正相关(r=0.836、0.688,P＜0.05).结论 anti-CCP抗体与MMP-3联合检测在RA诊断中效果显著,可提升RA诊断精准性,且RA患者疾病活动度与anti-CCP抗体、MMP-3呈正相关性,可为临床药物使用提供参考.
Abstract
Objective To study the diagnostic value of combined detection of anti-cyclic citrullinated peptide(anti-CCP)antibody and matrix metalloproteinase-3(MMP-3)in patients with rheumatoid arthritis(RA)and its correlation with disease activity.Methods Nine-ty-two RA patients admitted to Xinhua Hospital,Huainan Xinhua Medical Group from January 2021 to January 2023 were retrospectively selected as the RA group.Meanwhile,92 non RA autoimmune disease patients admitted during the same period and 92 healthy individuals undergoing physical examination were selected as the non RA group and control group,respectively.The RA group was divided into four subgroups based on disease activity scores in 28 joints(DAS28):high activity group(DAS28＞5.1,n=23),medium activity group(3.2＜DAS28＜5.1,n=23),low activity group(2.6＜DAS28＜3.2,n=23),and stable group(DAS28＜2.6,n=23).The levels of anti-CCP antibody and MMP-3 in RA group,non RA group and control group and the four groups with different joint disease activity were compared,and the value of anti-CCP antibody combined with MMP-3 in the diagnosis of RA was analyzed by receiver operating characteristic(ROC)curve.The correlation be-tween anti-CCP antibody and MMP-3 and disease activity in RA patients was analyzed using Spearman correlation analysis.Results The levels of serum anti-CCP antibody and MMP-3 in the RA group and non RA group were significantly higher than those in the control group,the levels of serum anti-CCP antibody and MMP-3 in the RA group were significantly higher than those in the non RA group,and the differences were sta-tistically significant(P＜0.05).The levels of serum anti-CCP antibody and MMP-3 in the high activity group were significantly higher than those in the stable group,low activity group,and medium activity group,the levels of serum anti-CCP antibody and MMP-3 in the medium ac-tivity group were higher than those in the stable group and low activity group,and the levels of serum anti-CCP antibody and MMP-3 in the low activity group were higher than those in the stable group,and the differences were statistically significant(P＜0.05).ROC curve showed that the area under the curve(AUC),sensitivity and specificity of a single anti-CCP antibody were 0.780,0.499 and 0.945,while the AUC,sensitivi-ty and specificity of a single MMP-3 were 0.769,0.749 and 0.949,respectively.The AUC,sensitivity and specificity of anti-CCP antibody combined with MMP-3 were 0.890,0.882 and 0.962,respectively.Spearman correlation analysis showed that anti-CCP antibody and MMP-3 were positively correlated with disease activity in RA patients(r=0.836,0.688;P＜0.01).Conclusion The combined detection of anti-CCP antibody and MMP-3 has significant effect in the diagnosis of RA,which can improve the diagnostic accuracy of RA.Moreover,the disease activity of RA patients is positively correlated with anti-CCP antibody and MMP-3,which can provide reference for clinical drug use.
关键词
类风湿性关节炎/基质金属蛋白酶-3/诊断/抗环瓜氨酸肽抗体/疾病活动度Key words
Arthritis,rheumatoid/Matrix metalloproteinase-3/Diagnosis/Anti-cyclic citrulline peptide antibody/Disease activity引用本文复制引用
基金项目
2020年度安徽省卫生健康软科学研究项目(2020WR03013)
出版年
2024
NETL
NSTL
万方数据