强直性脊柱炎患者检测HLA-B27、ASO及免疫球蛋白表达的临床意义

Clinical significance of detecting HLA-B27,ASO and immunoglobulin expression in patients with ankylosing spondylitis

目的分析强直性脊柱炎(AS)患者检测人类白细胞抗原B27(HLA-B27)、抗链球菌溶血素O(ASO)及相关免疫球蛋白亚型表达检测的临床意义。方法 85例AS患者作为研究组,同期正常健康体检人员35例作为对照组,比较两组HLA-B27、ASO及免疫球蛋白亚型(IgG、IgA、SIgA、IgM)水平,并评价两组炎症指数(BASDAI)和功能指数(BASFI),Spearman相关性分析各指标的相关性,受试者工作特征曲线(ROC)分析各指标诊断AS的价值。结果研究组HLA-27、ASO水平及阳性率均显著高于对照组,差异具有统计学意义(P<0.05)。研究组IgG、IgA、IgM水平显著高于对照组,差异有统计学意义(P<0.05),两组SIgA水平比较,差异无统计学意义(P>0.05)。研究组BASDAI、BASFI评分显著高于对照组,差异有统计学意义(P<0.05)。相关性分析结果显示,HLA-27、ASO分别与IgG、IgA、IgM存在显著正相关性(P<0.05),与SIgA无显著相关性(P>0.05)。HLA-27、ASO、IgG、IgA、IgM分别与BASDAI、BASFI存在显著正相关性(P<0.05),SIgA、BASDAI与BASFI无显著相关性。ROC曲线结果显示,HLA-B27、ASO、IgG、IgA、SIgA、IgM诊断AS的曲线下面积分别为0.725(95%CI:0.645~0.804)、0.826(95%CI:0.762~0.889)、0.798(95%CI:0.732~0.864)、0.872(95%CI:0.822~0.923)、0.682(95%CI:0.604~0.760)、0.671(95%CI:0.586~0.757)。结论 AS患者HLA-B27、ASO阳性率较高,免疫球蛋白水平异常,对这些指标进行检测有利于AS的诊断及病理探究。

Objective To analyze the clinical significance of detecting human leukocyte antigen B27(HLA-B27),anti-streptolysin O(ASO)and related immunoglobulin subtypes in patients with ankylosing spondylitis(AS). Methods 85 AS patients served as the study group,and 35 normal health checkups served as the control group. The levels of HLA-B27,ASO and immunoglobulin subtypes(IgG,IgA,SIgA,IgM)were compared between the two groups and evaluated the inflammation index(BASDAI)and functional index(BASFI)of two groups,Spearman correlation analysis of the correlation of each index,and receiver operating characteristic curve(ROC)was analyzed for the value of each index in diagnosing AS. Results The levels of HLA-27,ASO and the positive rate in the study group were significantly higher than those in the control group,and the differences were statistically significant(P<0.05). The levels of IgG,IgA,and IgM in the study group were significantly higher than those in the control group(P<0.05). There was no significant difference in the levels of SIgA between the two groups(P>0.05). The BASDAI and BASFI scores in the study group were significantly higher than those in the control group,and the differences were statistically significant(P<0.05).The results of correlation analysis showed that HLA-27 and ASO had significant positive correlations with IgG,IgA,and IgM(P<0.05),but no significant correlation with IgG2 and SIgA(P>0.05). HLA-27,ASO,IgG,IgA,and IgM had significant positive correlations with BASDAI and BASFI,respectively,while SIgA had no significant correlation with BASDAI and BASFI. The ROC curve results showed that the area under the curve for HLA-B27,ASO,IgG,IgA,SIgA,and IgM to diagnose AS were 0.725(95% CI 0.645 to 0.804),0.826(95%CI 0.762 to 0.889),0.798(95%CI 0.732~0.864),0.872(95%CI 0.822~0.923),0.682(95%CI 0.604~0.760),0.671(95%CI 0.586~0.757). Conclusion The positive rate of HLA-B27 and ASO in AS patients is relatively high,and the level of immunoglobulin is abnormal. The detection of these indicators is beneficial to the diagnosis and pathological exploration of AS.