强直性脊柱炎患者HLA-B27抗原表达与临床的相关性分析

Correlation analysis on HLA- B27 and clinical significance of the patients with ankylosing spondylitis

目的分析HLA-B27抗原与AS的临床相关性。方法对386例住院患者采用流式细胞术方法,选择136例健康献血者作为对照,检测2组患者T淋巴细胞膜上的HLA-B27抗原。结果 136例健康献血者中HLA-B27阳性率为11.0%,386例AS患者的HLA-B27抗原表达阳性率90.7%。其中表达阳性者发病年龄为(23.4±7.3)岁,表达阴性者为(37.8±13.6)岁,2组患者比较差异有统计学意义(P<0.05);男女患者HLA-B27抗原表达阳性率分别为92.7%(280/302)和83.3%(70/84),2组比较差异无统计学意义(P>O.05);与AS患者疾病活动性有关的检验指标(ESR,CRP,PLT)在B27阳性组均明显升高(P<0.05)。髋关节病变的严重程度与HLA-B27抗原阳性表达相关(P<0.01);AS患者的HLA-B27抗原表达阳性者周围关节累及和关节外表现最多见的分别为膝关节炎、踝关节炎和葡萄膜炎、肠炎。结论 AS患者与HLA-B27抗原表达有着很强的相关性;采用流式细胞技术检测临床AS患者T淋巴细胞HLA-B27表达有助于诊断和鉴别诊断,也有利于临床病情严重程度和预后的判断。

Objective To investigate the correlation analysis of clinical significance on Ankylosing Spondylitis （AS） and HLA - B27. Methods The positive frequency of HLA - B27 gene on the thymus lymphocyte membrane were detected by flow eytometer in 386 patients with AS and in 136 normal controls. Results The positive rate of HLA - B27 expression was 90.7% in patients with AS and 11.0% in normal controls （ P 〈 0.01 ）. Among the 386 AS patients, the diagnostic age of the HLA - B27 positive group and nega tive group were （ 23.4 ± 7.3 ） and （ 37.8 ±13.6 ） , respectively （ P 〈 0.01 ）. The positive rate of HLA - B27 expression was 92.7% （280/302） in male with AS and 83.3% （70/84） in female （P 〉0.05）. ESR, CRP and PLT were significantly higher in HLA -B27 positive group （P 〈 0.01 ）. There was positive correlation between the hip joint involvement and HLA- B27 expression in AS （P 〈 0. 01 ）. The around joint involvement and the besides joint involvement were the knee join arthritis, the ankle join arthritis, uveitis and enteritis in HLA - 1327 positive group. Conclusion The patients with AS are strongly associated with antigen HLA - 27. There is the close relationship between HLA- B27 and disease activity suggests in AS.