HLA-B27阳性急性前葡萄膜炎的临床特征

Clinical features of acute anterior uveitis with HLA-B27 positive

目的 :探讨HLA B2 7阳性急性前葡萄膜炎的诊断及临床特征。方法 :应用磁珠酶联免疫吸附试验对 74例急性前葡萄膜炎患者和 36例健康对照者血液中HLA B2 7抗原进行测定 ,并对HLA B2 7抗原阳性和阴性急性前葡萄膜炎患者的临床特征进行对比分析。结果 :急性前葡萄膜炎患者 74例中 ,HLA B2 7抗原阳性 35例 ,阳性率为 4 7 30 % ;健康对照者 36例 ,阳性 3例 ,阳性率为 8 33% ;两者有显著性差异 (χ2 =16 2 6 ,P <0 0 1)。HLA B2 7阳性急性前葡萄膜炎的临床特点有起病急、前房内有大量纤维渗出和细胞、角膜后沉着物呈细小、灰白色。一般为单眼发病 ,症状重于常见的特发性前葡萄膜炎 ,复发率较高。常伴有玻璃体混浊、黄斑囊样水肿和全身关节病变。结论 :HLA B2 7抗原与急性前葡萄膜炎明显相关 ,HLA B2 7相关性前葡萄膜炎的临床表现重于HLA B2 7阴性前葡萄膜炎 ,并常伴有全身脊柱关节病变。

Objective:To evaluate the diagnosis and clinical features of acute anterior uveitis with HLA-B27 positive.Methods:74 cases of consecutive patients with acute anterior uveitis and 36 cases healthy controls were tested with ELISA method for the HLA-B27 antigen.The clinical characteristics of acute anterior uveitis with HLA-B27 positive and negative patients were analyzed.Results:Of the 74 patients,35 cases(47.30%)were HLA-B27 positive and 3 cases(8.33%)of controls were positive.There was significant difference in positive rate between the acute anterior uveitis and controls(χ 2=16.26,P<0.01).The features of acute anterior uveitis with HLA-B27 positive were:sudden onset,often unilateral,much fibrinous and cellular exudates in the anterior chamber,fine keratic precipitates,often accompanying with posterior segment lesions and systemic arthritic diseases.Conclusions:HLA-B27 antigen is related to the acute anterior uveitis.The clinical features of acute anterior uveitis with HLA-B27 positive are severer than those of the HLA-B27 negative acute anterior uveitis.The HLA-B27 positive patients should be noted their systemic diseases.