强直性脊椎炎的临床与HLA-B27分析

Clinical Characteristic of Ankylosing Spondylitis and HLA B27

目的：了解本地区强直性脊椎炎的临床特征及其与ＨＬＡＢ２７的相关性。方法：用微量淋巴细胞毒试验对２４５例强直性脊椎炎患者进行ＨＬＡＢ２７抗原检测。结果：ＨＬＡＢ２７抗原阳性２２０例，阳性率９０％，抗原阳性组男女之比为２５∶１，抗原阴性组为３１∶１，两组间无明显差异，本病发病年龄大多在３０岁以内，占６５％。平均病程４５年。患者初发症状以腰痛为主，周围关节以髋膝关节受累居多。患者均有骶髂关节炎症改变，多为骶髂关节模糊、狭窄。脊椎异常主要表现为脊椎小关节模糊、椎间韧带钙化、椎骨质增生。结论：对长期不明原因的腰腿痛患者及早检测ＨＬＡＢ２７抗原对强直性脊椎炎的诊断有很大帮助。

Aim:to explore the relationship between the clinical characteristic of ankylosing spondylitis(AS) and HLA B27.Methods:245 patients with AS were collected and detected serologically for HLA B27 using specific antisera and complement in a microlymphocytotoxicity test.Results:HLA B27 is present in 90% of patients with AS and the ratio of male to female was 2.5∶1 in HLA B27 positive group and 3.1∶1 in the negative group.There was no significant difference between two groups. The disease was most common in 15 30 years of age (65%).The initial symptoms were mainly low back pain and stiffness,often worse in the early morning.Pain in the hips,knees was often present.Radiographs of the sacroiliac joints in early disease showed blurring of the margins,stenosis and irregular subchondral erosions. Similar changes were observed in the radiography of the spine.Conclusion:The detection of HLA B27 contribute to the early diagnosis of patients with AS.