HLA-B27在门诊疑似AS诊断中的意义  

作　　者：张宇 曾钊宇 梁丽仪 宋海涛 

机构地区：[1]广东医科大学附属高明区人民医院检验科,广东佛山528500

出　　处：《湖南中医药大学学报》2016年第A02期1351-1352,共2页Journal of Hunan University of Chinese Medicine

摘　　要：目的：讨论门诊疑似强直性脊柱炎（AS）诊断中 HLA-B27基因检测的意义.材料与方：对门诊疑似诊断为 AS 的889例患者的 HLA-B27阳性率、患者性别和初诊年龄进行统计分析,并与同期随机采集的506例健康人的HLA-B27阳性率进行比较.采用SPSS13.0统计软件.结果：889例门诊疑似AS患者中HLA-B27阳性率为44.77%（398/889）,其中男性患者的HLA-B27阳性率47.55%（339/713）与女性患者的35.52%（59/176）相比,差异具有显著统计学意义（χ2=11.23,P〈0.01）;对照组中HLA-B27阳性率为4.15%（21/506）,与疑似 AS 患者的阳性率相比, 呈显著统计学差异 （χ2=253.18,P 〈0.001）;男性患者发病高峰为11岁～20岁,而女性患者则为31岁～40岁.结论：本文调查的门诊疑似 AS 诊断患者中的 HLA-B27的阳性率（44.77%）明显高于对照组（4.15%）;男性患者的 HLA-B27阳性率显著高于女性患者,而且男性患者发病高峰为青少年时期（11岁～20岁）,早于女性患者,符合AS 多发于青年男性的临床特点.提示疑似 AS 患者门诊就诊时检测HLA-B27有助于提高初诊患者的诊断率,并可作为鉴别诊断的重要指标.Objective： discuss the diagnostic value of HLA-B27 gene in out-patient suspicious of Ankylosing spondylitis （AS）. Material and methods： Analyze statistically the positive rate of HLA-B27, the gender of the patients and the age of preliminary diagnosis from 889 out-patients suspicious of AS, and to compare with the positive rate of HLA-B27 from 506 normal people collected randomly in the same period. Adopt the statistics software of the SPSS13.0. Results： the positive rate of HLA-B27 was 44.77%（398/889）in out-patient suspicious of AS. Comparing the positive rate of HLA-B27 from male patients 47.55%（339/713） with that from female patients 35.52%（59/176）, there was significant statistical difference（χ2=11.23,P〈0.01）. The positive rate of HLA-B27 in the control was 4.15 %（ 21/506）, and comparing it with the positive rate of AS patients there is significant statistical difference（χ2=253.18,P〈0.001）. The peak period of developing the disease for male patients is 11-20, while the female patients 31-40. Conclusion： the positive rate of HLA-B27 in out-patients suspicious of AS in this investigation is obviously higher than the control; the positive rate of HLA-B27 in male patients is much higher than female patients, and the peak time of developing the disease for male patients is adolescence 11-20, earlier than female patients, in accordance to the clinical characteristic that AS favors adolescent males. It implies that the detection of HLA-B27 in out patients suspicious of AS, will contribute to the diagnostic rate of AS patients in the preliminary diagnosis, which could be used as one important index in differential diagnosis.

关 键 词：HLA-B27 强直性脊柱炎 PCR-SSP 

分 类 号：R2[医药卫生—中医学]