少儿强直性脊柱炎与幼儿类风湿性关节炎HLA-B27亚型的鉴别诊断

Susceptibility of juvenile ankylosing spondylitis and juvenile rheumatoid arthritis with subtypes of HLA-B27 allele in north China

目的 探讨HLA B2 7等位基因亚型与少年强直性脊柱炎和幼年类风湿性关节炎的关联。方法 用PCR SSP方法对 74人HLA B2 7等位基因亚型进行研究 ,其中少年强直性脊柱炎 32例 ,幼年类风湿性关节炎 2 8例 ,5个家系中患者的父亲或母亲 5例 ,正常对照组 9例 ,并进行关联分析。结果 本组人群的HLA B2 7等位基因由HLA B 2 70 4、 2 70 5、 2 70 2、 2 70 74种亚型组成 ,其中少年强直性脊柱炎患者HLA B2 7等位基因亚型频率为B 2 70 45 6 .2 5 %、B 2 70 5 40 .6 3%、B 2 70 23 .13% ;幼年类风湿性关节炎HLA B2 7等位基因亚型频率为B 2 70 5 6 0 .7%、B 2 70 42 8.5 7%、B 2 70 2 3.5 7%及B 2 70 7为 7.14% ;少年强直性脊柱炎与幼年类风湿性关节炎结果比较 ,HLA B 2 70 4基因频率在少年强直性脊柱炎组高于幼年类风湿性关节炎组 (RR =3 .2 1,P <0 .0 5 )。结论 少年强直性脊柱炎与HLA B 2 70 4等位基因亚型关联。对HLA B2 7等位基因亚型的检测可成为少年强直性脊柱炎和幼年类风湿性关节炎鉴别诊断中一个有价值的实验指标。

Objective To investigate the relationship between juvenile ankylosing spondylitis (JAS), juvenile rheumatoid arthritis (JRA) and subtypes of HLA-B27 in north China population. Methods With PCR-SSP, subtypes of HLA-B27 of 74 cases in groups of 32 JAS, 28 JRA, fathers or mothers of 5 patients and 9 health people were studied and their associations were analyzed. Results HLA-B*2704, *2705, *2702 and *2707 were found in the 74 case. In the JAS group, HLA-B*2704 was 56.25%, B*2705 was 40.63%, B*2702 was 3.13%; In the JRA group, HLA-B*2705 was 60.7%, B*2704 was 28.57%; B*2702 was 3.57% and B*2707 was 7.14%. Comparison between JAS and JRA showed that HLA-B*2704 is positively associated with the susceptibility of the JAS (RR=3.21, P <0.05). Conclusions The susceptibility of JAS is positively associated with subtypes HLA-B*2704. The subtypes of HLA-B27 may be a valuable marker in differential diagnosis of JAS and JRA. [