强直性脊柱炎患者HLA-B27基因分型及临床特征分析

目的:探讨强直性脊柱炎(AS)患者基本特征以及人类白细胞抗原B27(HLA-B27)基因分型检测的临床意义。方法:收集中日友好医院2018年1月~2019年12月间确诊的AS患者资料,对其外周血样本进行核酸提取,荧光定量PCR染料法检测HLA-B27基因及分型。结果:287例AS患者中HLA-B27基因阳性占82.9%;AS家族史患者占16.0%(一级亲属占14.3%,二级亲属占1.7%);伴发葡萄膜炎10.1%。238例HLA-B27基因阳性AS患者中HLA-B2704亚型占55.0%,HLA-B2705亚型42.4%,HLA-B2702亚型0.8%;HLA-B2704*HLA-B2705复合杂合子1.3%,HLA-B2705*HLA-B2708复合杂合子0.4%。男性AS患者就诊年龄、发病年龄显著早于女性AS患者(P<0.05;P<0.01)。HLA-B27基因阳性AS患者发病年龄显著早于HLA-B27基因阴性AS患者(P<0.05)。HLA-B2705亚型AS患者伴发葡萄膜炎比例显著高于HLA-B2704亚型AS患者(P<0.05)。结论:男性、HLA-B27基因阳性AS患者发病年龄较早,HLA-B2705亚型AS患者更易伴发葡萄膜炎。

Efficacy of multimodal cocktail periarticular injection with or without steroid in total knee arthroplasty

Background Multimodal cocktail periarticular injection （MCPI） with a large volume of low concentration local anesthetics, adrenaline, and anti-inflammatory agents such as non-steroidal anti-inflammatory drug or steroids have shown good pain control and improvement in range of motion after surgery. This study compares the efficacy of pain control after total knee arthroplasty, using multimodal cocktail periarticular injection with steroid or without steroid.