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目的探讨不同程度膝骨性关节炎患者血清组织蛋白酶D( cathepsin D ,CATD)、α1抗胰蛋白酶(alpha‐1 antitrypsin ,AAT)活性变化及其意义。方法分别收集健康人血清标本(对照组)及Ⅰ~Ⅳ期膝关节炎患者血清标本(观察组)各20份。运用酶联免疫吸附法(ELISA)测定每个标本的CATD、AAT活性,分析不同程度骨性关节炎患者血清CATD、AAT 的活性变化,并与正常对照组进行比较。结果与对照组比较,Ⅰ~Ⅱ期膝关节炎患者血清中CATD酶活性增高( P <0.05),且Ⅱ期高于Ⅰ期( P <0.05);而Ⅲ~Ⅳ期则活性降低(P <0.05),且Ⅳ期比Ⅲ期下降更明显(P <0.05)。与对照组比较,Ⅰ~Ⅱ期膝关节炎患者血清中AAT活性增高,且Ⅱ期比Ⅰ期活性高( P <0.05),而Ⅲ~Ⅳ期与对照组比较无统计差异( P >0.05)。结论不同期膝骨性关节炎患者血清中伴随着CATD、AAT两种酶活性改变,测定这两种血清酶活性有利于判断骨性关节炎软骨退变程度。“,”[Objective]To explore the serum activity changes of cathepsin D (CATD) and alpha‐1 antitryp‐sin (AAT) in different stages of osteoarthritis patients .[Methods]The serum samples were collected from 20 patients with stagesⅠ ~ Ⅳ knee osteoarthritis according to the Kellgren‐Lawrence (K‐L) criteria .And anoth‐er 20 healthy controls were also recruited .Enzyme‐linked immunosorbent assay (ELISA) was used to detect the serum activities of CATD and AAT .The data were analyzed by SPSS19 .0 software to determine whether the serum activities of CATD and AAT had changed or not for different stages of osteoarthritis and whether the differences were significant compared with healthy controls .[Results]Compared with healthy sera ,the ser‐um activity of CATD increased for stages Ⅰ ~ Ⅱpatients while that of CATD decreased for stages Ⅲ ~ Ⅳ ones .As for serum activity of AAT ,stagesⅠ ~ Ⅱincreased while stages Ⅲ ~ Ⅳhad no statistical difference com‐pared with healthy sera .[Conclusion]The serum activities of CATD and AAT vary during different stages of osteoarthritis .And testing these two serum enzymes may help to determine the degeneration degree of osteoar‐thritis cartilage in patients with osteoarthritis .