HLA-B27阳性急性前葡萄膜炎的危险因素分析

目的分析白细胞抗原(HLA)-B27阳性急性前葡萄膜炎(AAU)的可能危险因素。方法收集2013年11月至2019年12月单眼发作的急性非感染性前葡萄膜炎患者的临床资料,按照HLA-B27是否阳性,分为HLA-B27阳性AAU组和HLA-B27阴性AAU组,进行单因素方差分析,筛选出危险因素。再对筛选出的有统计学意义的因素进行二元Logsic回归分析。结果112例患者中HLA-B27阳性AAU组72例,HLA-B27阴性AAU组40例。单因素方差分析显示,是否有强直性脊柱炎(AS)、类风湿因子、治疗前眼压、发病至开始治疗的间隔时间,差异有统计学意义(P<0.05)。二元Logisuc回归分析显示,是否有AS、治疗前眼压为其独立危险因素。结论HLA-B27阳性AAU的独立危险因素可能是治疗前眼压、合并有AS。因此,临床应重视眼压监测、加强AS多学科治疗。

Objective To analyze the possible risk factors of acute anterior uveitis with human leukocyte anti Gen(HLA)-B27 positive,so as to better guide the clinical diagnosis and treatment.Methods A retrospective study was conducted from November 2013 to December 2019 in Huzhou first people's Hospital of Zhejiang Province.According to the clinical data of patients with acute uninfected anterior uveitis with monocular attack,they were divided into HLA-B27 positive AAU group and HLA-B27 negative AAU group according to whether HLA-B27 was positive or not.Then,binary Logistic regression analysis was carried out for the screened statistically significant factors.Results Among the 112 patients,72 were diagnosed as AAU with HLA-B27 positive and 40 as AAU with HLA-B27 negative.According to whether HLA-B27 was positive or not,single factor analysis of variance showed that:whether there was ankylosing spondylitis,rheumatoid facto,intraocular pressure before treatment,the interval from onset to the beginning of treatment,P value was less than 0.05.Then through the binary logistic regression analysis,whether there was AS and intraocular pressure before treatment,P value was less than 0.05,were independent risk factors.However,there was no significant difference between the two groups in age,gender,iris adhesion before treatment,ESR,CRP and antibody.Conclusion The independent risk factors of HLA-B27 positive AAU may be intraocular pressure before treatment and AS.Therefore,we should pay attention to intraocular pressure monitoring and strengthen the multi-disciplinary treatment of AS.