HLA-B27、CRP、ESR、RF以及Ig联合检测对强直性脊柱炎的诊断价值

Diagnostic value of combined detection of HLA-B27,CRP,ESR,RF and Ig for ankylosing spondylitis

目的探讨HLA-B27、C反应蛋白(CRP)、血沉(ESR)、类风湿因子(RF)以及免疫球蛋白(Ig)在强直性脊柱炎(AS)患者中的水平变化对AS的诊断价值。方法采用流式细胞术、免疫散射比浊法以及Westergren法,分别检测AS患者(209例)和健康体检者(99例)全血中的HLA-B27、CRP、RF及Ig(IgG、IgA、IgM)、ESR的水平,并进行统计学分析。结果 AS组HLA-B27、CRP、ESR阳性率及CRP、ESR双阳性率分别为98. 09%、62. 20%、40. 19%和34. 49%,高于对照组,差异有统计学意义(P <0. 05); AS组CRP、ESR、RF、IgG、IgA、IgM水平分别为(17. 92±2. 50) mg/L、(23. 21±2. 28) mm/h、(16. 95±24. 87) IU/m L、(13. 81±3. 64) g/L、(3. 18±2. 60) g/L、(1. 40±0. 58) g/L,高于对照组,除RF差异无统计学意义(P> 0. 05),其余指标与对照组相比差异有统计学意义(P <0. 05)。结论 CRP、ESR以及Ig水平变化与AS病情活动有关,可以作为监测AS病情变化的指标。HLAB27、CRP、ESR以及Ig联合检测能够有效提高AS的阳性率,在AS的辅助诊断中发挥着重要作用。

Objective To explore the diagnostic value of HLA-B27,C-reactive protein(CRP),erythrocyte sedimentation rate(ESR),rheumatoid factors(RF)and immunoglobulin(Ig)in ankylosing spondylitis(AS).Methods The flow cytometry analysis,immune turbidity analysis and Westergren method were used to detect the levels of HLA-B27,CRP,RF,IgG,IgA,IgM and ESR in AS patients(n=209)and the healthy control(n=99),respectively.Results The positive rates of HLA-B27,ESR,CRP and the positive rate of both ESR and CRP in AS group were 98.09%,65.99%,40.19%and 34.48%,respectively,higher than healthy control(P<0.01).The levels of CRP,ESR and Ig(IgG,IgA,IgM)were(17.92±2.50)mg/L,(23.21±2.28)mm/h,(16.95±24.87)IU/m L,(13.81±3.64)g/L,(3.18±2.60)g/L,(1.40±0.58)g/L,respectively,higher than healthy control(P<0.05),except RF(P<0.05).Conclusion Changes of CRP,ESR and Iglevels are associated with AS disease activity,and it can be used as a monitoring condition of reaction indicator.The combined detection of HLA-B27,ESR,CRP and Igin patients with AS is helpful for guidance of diagnosis and treatment of AS.