强直性脊柱炎患者HLA-B27核酸、炎症指标、免疫指标的临床意义分析  

Analysis on clinical significance of HLA-B27 nucleic acid,inflammatory indicators and immune indicators in patients with ankylosing spondylitis

作　　者：张冬青 赵娇 龙丽娟 ZHANG Dongqing;ZHAO Jiao;LONG Lijuan(Department of Clinical Laboratory,Fourth Medical Center,PLA General Hospital,Beijing 100048,China)

机构地区：[1]中国人民解放军总医院第四医学中心检验科,北京100048

出　　处：《检验医学与临床》2023年第13期1846-1849,共4页Laboratory Medicine and Clinic

摘　　要：目的探讨人类白细胞抗原B27(HLA-B27)核酸、炎症指标、免疫指标在强直性脊柱炎(AS)患者中的临床意义。方法纳入73例AS患者(AS组)及73例健康体检者(健康对照组),检测外周血HLA-B27核酸、炎症指标[超敏C反应蛋白(hs-CRP)、前清蛋白(Prea)]、免疫指标[免疫球蛋白(Ig)A、IgG、IgM、IgE、补体C3(C3)、补体C4(C4)、血清总补体(CH50)]及抗链球菌溶血素O(ASO)、类风湿因子(RF)、红细胞沉降率(ESR)。采用受试者工作特征曲线分析HLA-B27核酸、hs-CRP和ESR对AS的诊断效能。结果AS组HLA-B27核酸阳性率及ESR、hs-CRP、ASO、IgA水平显著高于健康对照组(P<0.05),hs-CRP在不同分级AS患者中比较,差异均有统计学意义(P<0.05);AS组Prea、RF、IgG、IgM、IgE、C3、C4、CH50与健康对照组相比,差异无统计学意义(P>0.05)。HLA-B27核酸、hs-CRP和ESR联合检测诊断AS的曲线下面积为0.996(95%CI:0.991~0.999),大于各项指标单独诊断(P<0.05)。结论HLA-B27核酸、hs-CRP及ESR联合检测能够有效提高AS的检出率,在AS的辅助诊断中发挥着重要作用。Objective To explore the clinical significance of human leukocyte antigen B27(HLA-B27)nucleic acid,inflammatory indexes and immunological indexes in the patients with ankylosing spondylitis(AS).Methods Seventy-three patients with AS(AS group)and 73 subjects undergoing physical examination(healthy control group)were included.The levels of peripheral blood HLA-B27 nucleic acid,inflammatory indicators[hypersensitivity-C-reactive protein(hs-CRP),prealbumin(Prea)]and immune indexes[IgA,IgG,IgM and IgE,complement C3(C3),complement C4(C4),serum total complement(CH50)],antistreptolysin O(ASO),rheumatoid factor(RF)and erythrocyte sedimentation rate(ESR)were detected.Receiver operating characteristic curve was used to analyze the diagnostic efficacy of HLA-B27 nucleic acid,hs-CRP and ESR.Results The HLA-B27 nucleic acid positive rates,ESR,hs-CRP,ASO and IgA levels in the AS group were significantly higher than those in the healthy control group(P<0.05).The hs-CRP level had statistical difference among the patients with different grades of AS(P<0.05).The levels of Prea,RF,IgG,IgM,IgE,C3,C4 and CH50 had no statistical difference between the AS group and healthy control group(P>0.05).The area under the curve of HLA-B27 nucleic acid,hs-CRP and ESR combined detection in the diagnosis of AS was 0.996(95%CI:0.991—0.999),which was greater than the individual diagnosis of various indicators(P<0.05).Conclusion The combined detection of HLA-B27 nucleic acid,hs-CRP and ESR could effectively increase the AS detection rate and plays an important role in the AS assisted diagnosis.

关 键 词：强直性脊柱炎 人类白细胞抗原B27 超敏C反应蛋白 抗链球菌溶血素O 红细胞沉降率 免疫球蛋白 

分 类 号：R593.23[医药卫生—内科学]