流式细胞仪检测人类白细胞抗原B27对强直性脊柱炎的诊断价值  

Diagnostic value of HLA-B27 by flow cytometer in ankylosing spondylitis

作　　者：杨清锐[1] 张源潮[1] 房学强[2] 马春燕[3] 孙红胜[1] 

机构地区：[1]山东大学山东省立医院风湿免疫科,山东济南250021 [2]山东大学公共卫生学院流行病与卫生统计研究所,山东济南250012 [3]山东大学山东省立医院中心实验室,山东济南250021

出　　处：《中国实用内科杂志》2007年第7期526-528,共3页Chinese Journal of Practical Internal Medicine

摘　　要：目的探讨人类白细胞抗原B27(HLA-B27)在强直性脊柱炎(AS)诊断中的意义。方法研究样本为2001年7月至2005年6月山东大学山东省立医院风湿免疫科住院的强直性脊柱炎患者(133例)及正常健康体检者(88名),采用诊断试验的研究方法,分析流式细胞仪检测HLA-B27对强直性脊柱炎的诊断价值。结果横断面研究资料221例中,AS133例。AS组HLA-B27阳性率明显高于健康对照组(P=0.000)。受试者运算特征(ROC)曲线下方面积为90.5%,提示HLA-B27对AS诊断具有重要意义。根据临床实际意义和ROC曲线,选取HLA-B27的3个截断点11.55%、46.60%和85.25%,敏感性分别为94.7%、90.2%和63.6%,特异性分别为56.8%、92.0%和95.4%。46.6%截断点能最大程度兼顾敏感性和特异性。以1984年AS纽约修订标准为基础,加上HLA-B27大于46.6%作为诊断AS的条件,其特异性则由98%上升至99.84%。以欧洲脊柱关节病研究组(ESSG)标准为基础,加上HLA-B27大于46.6%作为诊断AS的条件,其特异性则由87%上升至98.96%。结论HLA-B27流式细胞仪检测值大于46.6%对于诊断AS具有重要意义。Objective To investigate the diagnostic value of HLA-B27 in ankylosing spondylitis（AS）. Methods A diagnostic test was employed in the study. The patients with ankylosing spondylitis and the controls in Shandong Provicial Hospital from 2001-2005 were enrolled in the study. HLA-B27 was detected by flow cytometer assay when recruited. SPSS 13. 0 was used for statistical analysis. Results Totally 133 patients with AS and 88 controls were available in the study. HLA-B27 was significantly different between AS group and the controls （ P = 0. 000 ）. The areas below ROC curve was 90. 5%. Three cut-off points of HLA-B27,11.55% ,46. 6% and 85.25% ,were selected based on clinical practice and ROCcurve,and the sensitivity was 94. 7% ,90. 2% and 63. 6%, the specificity was 56. 8% ,92.0% and 95.45%. Conclusion HLA-B27 which is more than 46. 6% is a valuable marker for the diagnosis of AS.

关 键 词：脊柱炎 强直性 HLA—B27 流式细胞仪 诊断试验 

分 类 号：R5[医药卫生—内科学]