强直性脊柱炎患者HLA-B27和免疫指标检测的临床意义

Clinical Significance of Determination of HLA-B27 and Immuno-Markers in Patients with Ankylosing Spondylitis

目的:探讨HLA-B27和免疫指标在强直性脊柱炎(AS)患者的临床意义。方法:采用流式细胞术检测147例AS患者、95例正常对照者的HLA-B27、CD3+T、CD4+T、CD8+T、CD19+B,用免疫比浊法检测IgA、IgG和IgM。结果:AS患者HLA-B27、CD3+T、CD4+T淋巴细胞的百分率及CD4+/CD8+的比值、血清IgA、IgG均明显高于正常对照组(P<0.01);CD8+T淋巴细胞的百分率低于正常对照组(P<0.05);CD19+B淋巴细胞的百分率高于正常对照组(P<0.05);IgM与正常对照组相比无显著性差异。结论:HLA-B27、CD3+T、CD4+T与AS密切相关,提示,HLA-B27与CD3+T、CD4+T、CD4+/CD8+的比值可作为AS辅助诊断指标。

Objective To explore the significance of presence of changes HLA - B27 and of other immuno - markers in patients with ankylosing spondylitis（AS）. Methods HLA-B27, CD3^＋T, CD4^＋T, CD8^＋T, CD19^＋B positive rate （with FCM）, serum IgA, IgG, IgM levels （with immuno- turbidity） were determined in 147 patients with AS as well as in 95 controls. Results CD3^＋ T lymphocyte, CD4^＋T lymphocyte positive rate and the ratio of CD4^＋/CD8^＋ , serum IgA, IgG levels were significantly higher in patients than those in the controls （ P 〈 0.01 ）. The CD19^＋ B lymphocyte positive rate was also higher in patients than that in controls （ P 〈 0.05 ）, the CD8^＋ T lymphocyte positive rate was lower in patients that in controls （ P 〈 0.05 ）. The serum IgM level was not significantly different （ vs controls, P 〉 0.05）. Conclusion HLA - B27, CD3^＋ T, CD4^＋ T contents were closely related to development of AS. HLA -B27, CD3^＋T, CD4^＋T, CD4^＋/CD8^＋ could be used as diagnostic indicators for AS.