HLA-B27阳性与阴性中轴型脊柱关节炎临床特征分析  

Clinical features of HLA-B27 positive and negative patients with axial spondyloarthritis.

作　　者：毛绍园 张秀灵[1] 尚静静[1] 邹桂香[1] 刘念[1] 段新旺[1] DUAN Xinwang;LIU Nian;ZOU Guixiang;SHANG Jingjing;ZHANG Xiuling;MAO Shaoyuan(Department of Rheumatology,The Second Affiliated Hospital of Nanchang University,Nanchang 330006,China)

机构地区：[1]南昌大学第二附属医院风湿免疫科,330006

出　　处：《实用医学杂志》2017年第12期1992-1995,共4页The Journal of Practical Medicine

摘　　要：目的:探讨HLA-B27在中轴型脊柱关节炎疾病活动与临床特征中的作用。方法:前瞻性收集并观察研究112例中轴型SpA患者的病例资料,分析82例HLA-B27阳性和30例HLA-B27阴性中轴型SpA患者的临床表现及实验室检查结果。数据来源为国家风湿病数据中心。结果:(1)HLA-B27阴性患者较阳性患者平均发病年龄明显偏晚,男女比例、病程无显著差异。(2)HLA-B27阴性组的严重髋关节病变、外周关节炎、附着点炎及全身症状的比率均明显低于HLA-B27阳性组,家族聚集现象、葡萄膜炎和脊柱的放射学改变在两组差异无显著性。(3)疾病活动性指标的改变包括血沉和C-反应蛋白的升高HLA-B27阴性组明显低于HLA-B27阳性组。结论:中轴型SpA与HLA-B27相关性强,HLA-B27阳性患者平均发病年龄明显偏早,病情相对较重,预后较差。Objective To investigate the effects of HLA?B27in disease activity and the clinical featuresof axial spondyloarthritis(SpA).Methods Clinical data of112patients with axial SpA was collected and studiedprospectively.Clinical manifestations and laboratory examination results of82HLA?B27positive and30HLA?B27negative patients with axial SpA were analyzed.Data source was from Chinese Rheumatism Data Center.Results(1)The average age of onset of HLA?B27negative patients was significantly later than that of the positive patients,and there was no significant difference in the course of disease and the proportion of male and female patients.(2)The ratio of severe lesion of hip,peripheral arthritis,attachment inflammation and systemic symptoms ofHLA?B27negative group were significantly lower than those of HLA?B27positive group.Familial aggregationphenomenon,uveitis and spine radiology changes in two groups had no significant difference.(3)The changes ofdisease activity index including erythrocyte sedimentation rate and C?reactive protein increased in HLA?B27negative group was significantly lower than those in HLA?B27positive group.Conclusion There is strong correlationbetween axial SpA and HLA?B27.The average age of onset of HLA?B27negative patients was significantly laterthan that of the positive patients.HLA?B27negative patients manifested severe symptoms and worse prognosis.

关 键 词：中轴型脊柱关节炎 HLA.B27抗原 临床特征 

分 类 号：R593.2[医药卫生—内科学]