HLA-B27阴性和阳性强直性脊柱炎患者临床情况比较

Comparison of Clinical Features in Ankylosing Spondylitis Patients with HLA-B27 Negative Expression and Positive Expression

目的比较HLA-B27检测阴性与阳性的确诊强直性脊柱炎(AS)患者临床情况。方法用流式细胞仪对在本院确诊的301例AS患者进行人类白细胞抗原B27(HLA-B27)检测,并对HLA-B27阴性和阳性患者进行比较研究。结果①HLA-B27阴性和阳性患者男性发病率明显高于女性,阴性与同性别阳性患者平均发病年龄明显偏晚。②HLA-B27阴性患者以31～45岁为主,阳性患者以16～30岁为主。③HLA-B27阴性和阳性患者首发症状均以中轴关节炎和外周关节炎为主。阴性和阳性患者主要临床表现上均以出现下腰疼痛,髋部疼痛为主。阴性患者出现全身症状(包括发热、盗汗和乏力)明显少于阳性患者。结论 HLA-B27阴性患者比同性别阳性患者平均发病年龄明显偏晚,部分阴性患者病情相对较轻。HLA-B27阴性和阳性患者发病上的差异在对HLA-B27检测阴性的疑似患者诊断中应得到重视。

Objective To compare the clinical situation of the patients diagnosed as ankylosing spondylitis（AS） with negative expression and positive expression of human leukocyte antigen B27（HLA-B27）.Methods Use flow cytometry to measure HLA-B27 among the 301 patients diagnosed as AS in our hospital.And a comparative analysis has been done between the HLA-B27 negative and HLA-B27 positive patients.Results ①The incidence in male was significantly higher than in female in HLA-B27 negative expression group and positive expression group.The average onset age of HLA-B27-negative patients are older than those of the positive ones of the same sex;②The age of the patients with HLA-B27 negative expression was mainly 31～45,and the positive ones 16～30.③The major first symptoms of both the positive and negative patients were axial and peripheral arthritis.The major clinical symptoms include low back pain and hip pain.The rate of systemic symptom such as fever,night sweat and fatigue in negative patients was significant lower than that in the positive group.Conclusion The average age and onset age of HLA-B27-negative patients are older than those of the positive ones of the same sex,and part of HLA-B27 negative patients＇ condition was relatively mild.The different clinical features of HLA-B27 negative expression and positive expression patients call for due attention in diagonosing suspected AS patients with negative HLA-B27 expression.