幼年强直性脊柱炎人类白细胞抗原-B27定量检测与骶髂关节CT影像学分级的相关性  

Correlation between Quantitative Detection of Human Leukocyte Antigen-B27 and Multislice Computed Tomography Signs in Juvenile Ankylosing Spondylitis

作　　者：李胜男[1] 吴凤岐[1] 鲁杰[1] 杨洋[1] 袁新宇[1] 刘哲伟[1] 

机构地区：[1]首都儿科研究所附属儿童医院风湿免疫科,北京100020

出　　处：《实用儿科临床杂志》2012年第9期681-683,共3页Journal of Applied Clinical Pediatrics

摘　　要：目的探讨幼年强直性脊性炎(JAS)人类白细胞抗原-B27(HLA-B27)定量检测与骶髂关节CT影像学分级之间的相关性。方法总结30例JAS患儿临床资料,全部病例均行双侧骶髂关节CT影像学分级。均行HLA-B27流式细胞术定量检测,检测结果采用专用HLA-B27分析软件进行分析,以CD3.PE标记的T淋巴细胞设门并检测这群细胞HLA-B27+的平均荧光强度并与界值相比较,≥仪器设定的界值(146～148)为阳性,否则为阴性。采用SPSS 18.0软件(非参数秩和检验)进行统计分析。结果共30例。男28例,女2例;临床表现为髋关节、膝关节或下肢疼痛,少数主诉腰背及足部痛。CT显示骨质硬化及囊变12例(40%);关节骨破坏11例(36%);关节间隙改变7例(23%);骶髂关节面模糊6例(20%);真空现象4例(13%)。CT分级0级8例,Ⅰ级5例,Ⅱ级8例,Ⅲ级9例。Ⅰ级与Ⅱ级之间,Ⅱ级与Ⅲ级之间HLA-B27水平比较差异均无统计学意义(Pa>0.05),Ⅰ级与Ⅲ级之间HLA-B27水平比较差异有统计学意义(P<0.01)。Ⅲ级病例的HLA-B27水平大于Ⅰ级。结论 HLA-B27定量分析与骶髂关节CT分级之间存在一定相关性。提示HLA-B27定量检测可作为一项JAS的评估指标,为早期判断病情、评估预后、指导治疗提供新的线索。Objective To investigate the relationship between quantitative detection of human leukocyte antigen （HLA） - B27 and multislice spiral （MSCT） signs in juvenile ankylosing spondylitis （JAS）. Methods Thirty patients with JAS accepted both MSCT examination and quantitative detection of HLA - B27 by flow cytometry （FCM）. The data of FCM was analyzed by dedicated HLA - B27 software package. And the median channel fluorescent intensities of the gated T - cells labeled with phycoerythrin（PE） and CD3 were measured. All the resuhs were regarded as positive with a higher fluorescent intensity than the threshold（ 146 - 148 ） , and negative with a lower one. The data were statistically analyzed by using the software of SPSS 18.0（ non - parametric rank test）. Results Among these 30 cases ,28 cases were male,2 ca- ses were female ; Clinical symptoms were coxa, knee or leg pain, and a few of back and foot pain. MSCT showed the changes of sacroiliac joint ： arthrosclerosis and cystic changes in 1：2 cases （40%） ;bone destruction in Ⅱ cases （36%） ;joint gap change in 7 cases （23%） ;sacroiliac joint surface fuzzy in 6 cases（20% ） ;vacuum sign in 4 cases（13% ）. Grade 0 in 8 cases,and grade I in 5 cases,grade Ⅱ in 8 cases,grade Ⅲ in 9 cases. There were no statistical difference between grade I and Ⅱ , grade Ⅱ and m for the levels of HLA - B27 （ P 〉 0.05 ）, but there was statistical difference between grade I and grade Ⅲ （ P 〈 0.01 ）. The quantitative expression of HLA - B27 in grade Ⅱ was bigger than that in grade I Conclusions The quantitative expression of HLA - B27 is different in JAS children;There is correlation between quantitative detection of HLA - B27 and MSCT signs. The Quantitative HLA - B27 examination can be used as an index for early diagnosis of JAS.

关 键 词：幼年强直性脊柱炎 人类白细胞抗原-B27 骶髂关节计算机断层扫描 流式细胞术 定量检测 

分 类 号：R725.9[医药卫生—儿科]