HLA-B27阴性与阳性强直性脊柱炎的对比研究

COMPARATIVE STUDY ON HLA B27 NEGATIVE AND POSITIVE PATIENTS WITH ANKYLOSING SPONDYLITIS

目的：了解ＨＬＡＢ２７在强直性脊柱炎（ＡＳ）发病及病情活动中的作用。方法：对比分析５１例ＨＬＡＢ２７阴性〔Ｂ２７（－）〕ＡＳ患者和１０２例病程相同的ＨＬＡＢ２７阳性〔Ｂ２７（＋）〕ＡＳ患者（１∶２配对）的临床表现及实验室检查结果。结果：Ｂ２７（－）组与Ｂ２７（＋）组最明显的差异是前者以女性多见，平均发病年龄偏晚（Ｐ值分别＜００１和００５），且临床上较少出现全身症状、外周关节炎及严重的髋关节病变（Ｐ均＜００５），但合并类风湿关节炎明显多于阳性组（Ｐ＜００１），家族聚集现象、虹膜睫状体炎和脊柱的Ｘ线片改变在两组无差异。病情活动性指标的改变包括血沉和Ｃ反应蛋白的升高在Ｂ２７（－）组明显少于Ｂ２７（＋）组（Ｐ均＜００１）。结论：Ｂ２７（－）ＡＳ患者病情相对较轻，预后较好；

Objective:To investigate the possible role of HLA B27 in the pathogenesis of ankylosing spondylitis (AS).Methods:The clinical and laboratory manifestations of 51 HLA B27 negative (-) patients with ankylosing spondylitis (AS) were analyzed and compared with those of 102 B27 positive (+) patients whose mean duration of disease was similar to those of the B27(-) patients.Results:The B27(-) group tended to have more females and had later onset of disease ( P <0 05 or <0 01).Fewer B27(-) patients developed constitutional symptoms,peripheral arthritis and severe destructive lesions in hip joints ( P <0 05).However,the B27(-) patients were more frequently associated with rheumatoid arthritis ( P <0 01).There was no significant difference in familial aggregation,acute anterior uveitis and X ray“bamboo spine”lesions between two groups.The parameters of disease activity were increased less significantly in B27(-) patients than those in B27(+) patients.Conclusion:B27(-) AS patients have mild symptoms and favorable prognosis.B27(-) AS might have different pathogenesis compared to B27(+) AS.