HLA-B_(27)阳性与阴性的强直性脊柱炎临床表现的异同及其对辨证的意义  

Similarities and Differences Between Clinical Manifestations of HLA-B_(27) Positive and Negative Ankylosing Spondylitis and Their Significance to Syndrome Differentiation

作　　者：陈永前 娄玉钤 陈传榜 

机构地区：[1]河南风湿病医院河南风湿病研究所,河南郑州450045

出　　处：《风湿病与关节炎》2018年第2期9-13,共5页Rheumatism and Arthritis

基　　金：国家中医药管理局2014年全国名老中医药专家娄多峰传承工作室建设项目(国中医药人教发[2014]20号)

摘　　要：目的:探讨HLA-B_(27)阳性与阴性的强直性脊柱炎临床表现的异同及其对强直性脊柱炎中医辨证的临床意义。方法:将河南风湿病医院强直性脊柱炎数据库(HFAS数据库)中收录的379例患者按HLA-B_(27)阳性与阴性分为HLA-B_(27)阳性组和HLA-B_(27)阴性组,采用SPSS 19.0统计软件分析2组在关节表现、关节外表现及体格检查方面的区别与联系。结果:379例强直性脊柱炎患者中,337例检查HLA-B_(27),其中HLA-B_(27)阳性组241例,HLA-B_(27)阴性组96例。通过对2组183个关节表现及关节外表现、7项体格检查进行统计分析,2组间差异有统计学意义(P<0.05)的临床表现共4项,其中在动则气喘、胸廓活动度上HLA-B_(27)阳性组较明显、较差;而在四肢不温,疼痛性质(热痛)上HLA-B_(27)阴性组较明显。结论:HLA-B_(27)阳性者在"气虚、瘀血"的临床表现上较HLA-B_(27)阴性者明显,而HLA-B_(27)阴性者在"阳虚、热邪"的临床表现上较HLA-B_(27)阳性者明显。Objective:To explore the similarities and differences of clinical manifestation between HLA-B_(27) positive and negative ankylosing spondylitis and their clinical significance to syndrome differentiation.Methods:Three hundred and seventy-nine cases from the ankylosing spondylitis database of Henan Rheumatism Hospital(HFAS database)were divided into a HLA-B_(27) positive group and a HLA-B_(27) negative group,using the statistical software SPSS 19.0 to analyze the similarities and relationship between the two groups on the articular manifestations,extra articular manifestations and physical performance.Results:HLA-B_(27) was tested among 337 cases,among which 241 cases were in the HLA-B_(27) positive goup and 96 cases were in the HLA-B_(27) negative group.According to the statistic analysis for 183 articular manifestations and extra articular manifestations and 7 physical examination of the two groups,the difference was statistically significant(P < 0.05)among 4 clinical manifestations,among which activity-caused asthma and thoracic activity were obvious in the HLA-B_(27) positive group,and cool limbs and heat pain were obvious in the HLA-B_(27) negative group.Conclusion:Clinical manifestations of patients in the HLA-B_(27) positive group were qi deficiency and blood stasis,which are more obvious than those in the HLA-B_(27) negative group,while those of the HLA-B_(27) negative group are more obvious than those of the HLA-B_(27) positive group in yang deficiency and pathogenic heat.

关 键 词：脊柱炎 强直性 HLA-B27 临床表现 HFAS数据库 中医辨证 临床研究 

分 类 号：R259[医药卫生—中西医结合]