流式细胞法检测人类白细胞抗原B27/B7表达在诊断强直性脊柱炎中的价值

Clinical value of HLA-B27/B7 expression detected by flow cytometry for the diagnosis for ankylosing spondylitis

目的探讨流式法检测人类白细胞抗原B27/B7(HLA-B27/B7)在临床上对强直性脊柱炎(AS)的诊断价值。方法采用两色流式细胞术检测121例AS患者(AS组)、157例其他原因引起的腰腿痛患者(非AS组)和88例健康人(对照组)淋巴细胞HLA-B27及HLA-B7抗原的表达率及表达强度(MnX)。结果 AS组HLA-B27表达率、MnX和阳性率分别为(90.55±25.31)%、(16.87±9.13)%、90.9%,明显高于非AS组及对照组(P<0.05);非AS组上述各项指标与对照组相比差异无统计学意义(P>0.05)。将流式细胞法检测HLA-B27表达率、MnX及2项指标联合分别用于临床AS的诊断,灵敏度依次为90.9%、94.2%、98.3%,特异度依次为89.8%、84.5%、83.7%,卡方检验显示,联合检测时灵敏度显著高于单独检测表达率(P<0.05),且特异度差异无统计学意义(P>0.05)。结论流式细胞法检测HLA-B27对AS的诊断和鉴别诊断准确、有效,是一种很有价值的实验诊断方法。

Objective To analyze of the diagnostic value of detection of HLA-B27/B7 by flow cytometry for ankylosing spondylitis（AS）.Methods Flow cytometry was used to determine the fluorecence positive percentage and mean fluorecence of HLA-B27/B7 in lymphocytes in 121 patients with AS （AS group）,157 backleg pain patients without AS（non-AS group）,and 88 health controls（control group）,and results were analyzed statistically.Results Fluorecence positive percentage,mean fluorescence and positive percentage of HLA-B27 in AS group were （90.55±25.31）%,（16.87±9.13）%,90.9% respectively,which were significantly higher than those in non-AS group and control group（P0.05）.No significantly difference between non-AS group and controls were demonstrated in the results.Fluorecence positive percentage,mean fluorescence and both of them,detected by flow cytometry,were with the diagnostic sensitivity of 90.9%,94.2% and 98.3%,specificity of 89.8%,84.5% and 83.7%.The sensitivity of combined detection was significantly higher than of single fluorecence positive percentage detection （P0.05）,and the specificity was close（P0.05） by Chi-Square test.Conclusion The determination of HLA-B27 by flow cytometry could be an accurate and effective method for the diagnosis and differential diagnosis of AS.