闽西地区HLA-B27基因分型检测在脊柱关节炎中的应用研究  

Application of HLA-B27 Genotyping in the Diagnosis of Spinal Arthritis in Western Fujian

作　　者：李曼 谢永欣[1] 张洪彬[1] 张满娥[1] 巫永兰 曾宪林 卢志华[1] LI Man;XIE Yong-xin;ZHANG Hong-bin;ZHANG Man-e;WU Yong-lan;ZENG Xian-lin;LU Zhi-hua

机构地区：[1]龙岩市第二医院,福建龙岩364000

出　　处：《风湿病与关节炎》2022年第10期11-14,31,共5页Rheumatism and Arthritis

基　　金：龙岩市联合资金项目(2020LYF17052)。

摘　　要：目的:调查闽西地区脊柱关节炎(SpA)患者与健康人群中人类白细胞抗原B27(HLA-B27)及基因亚型的分布情况,探讨不同亚型与疾病表型的关系。方法:采用聚合酶链式反应-序列特异性引物法(PCR-SSP)定性检测全血样本中人类白细胞抗原HLA-B*2704、HLA-B*2705等HLA-B27等位基因;采用SPSS 23.0软件分析数据。结果:①SpA患者及对照组中HLA-B27阳性率分别为76.89%和8%,2组比较,差异有统计学意义(P<0.05);②共检出5个HLA-B27基因亚型,分别为HLA-B*2702、HLA-B*2704、HLA-B*2705、HLA-B*2708、HLA-B*2710,以HLA-B*2704基因亚型最常见。③在SpA中,HLA-B27阳性患者的起病年龄、发病至确诊时间均明显小于HLA-B27阴性患者,且SpA家族史比例更高(P<0.05)。④在SpA中,HLA-B*2705阳性组指(趾)炎、外周关节炎发生率显著高于HLA-B*2704阳性组(P<0.05)。结论:①闽西地区汉族人群HLA-B27与SpA密切相关,以HLA-B*2704基因亚型为主,可作为本地区SpA诊断的重要依据。②在SpA患者中,HLA-B27阳性患者起病年龄更小,SpA家族史阳性率更高,在亚型分布上HLA-B*2705阳性组指(趾)炎、外周关节炎比例更高,为本地区SpA患者预测病情提供帮助。Objective:To investigate the distribution of HLA-B27 and its subtypes in patients with spinal arthritis(SpA)and healthy people in Western Fujian,and to explore the relationship between different subtypes and disease phenotype.Methods:HLA-B27 alleles such as human leukocyte antigen HLA-B*2704 and HLA-B*2705 in whole blood samples were qualitatively detected by PCR-SSP.Software SPSS 23.0 was used to analyze the data.Results:①The positive rates of HLA-B27 in the SpA patients and the control group were 76.89%and 8%respectively.The difference between the two groups was statistically significant(P<0.05);②Five HLA-B27 gene subtypes were detected,including HLA-B*2702,HLA-B*2704,HLA-B*2705,HLA-B*2708,and HLA-B*2710,with HLA-B*2704 gene subtype being the most common.③In SpA patients,the age of onset and the time from onset to diagnosis of the HLA-B27 positive ones were significantly lower than those of the HLA-B27 negative ones,and the proportion of family history of SpA was higher(P<0.05).④In SpA patients,the incidence of finger(toe)inflammation and peripheral arthritis in the HLA-B*2705 positive group was significantly higher than that in the HLA-B*2704 positive group(P<0.05).Conclusion:①HLA-B27 is closely related to SpA in the Han population in this region,mainly HLA-B*2704 genotype,which can be used as an important basis for the diagnosis of SpA in this region.②Among SpA patients,HLA-B27 positive patients were younger at onset,had a higher positive rate of family history of SpA,and had a higher proportion of finger(toe)inflammation and peripheral arthritis in the subtype distribution of HLA-B*2705 positive group,which provided help for the prediction of SpA patients'condition in this region.

关 键 词：强直性脊柱炎 脊柱关节炎 人类白细胞抗原B27 基因分型检测 闽西地区 

分 类 号：R684.3[医药卫生—骨科学]