关于不同HLA-B27基因亚型强直性脊柱炎患者合并心血管疾病风险的探讨  

A Study of Risk of Cardiovascular Disease in Ankylosing SpondylitisPatients with Different HLA-B27 Gene Subtypes

作　　者：赵严亮 王健美 胡植双 侯学伶 郝世奇 张柳 张旭 徐翠玲 银广悦 ZHAO Yanliang;WANG Jianmei;HU Zhishuang;HOU Xueling;HAO Shiqi;ZHANG Liu;ZHANG Xu;XU Cuiling(Clinical Laboratory,Hebei Petrochina Central Hospital,Langfang 065000,China;Rheumatology and Immunology Department,Hebei Petrochina Central Hospital,Langfang 065000,China;Ultrasonography Lab,Hebei Petrochina Central Hospital,Langfang 065000,China)

机构地区：[1]河北中石油中心医院检验科,河北廊坊065000 [2]河北中石油中心医院风湿免疫科,河北廊坊065000 [3]河北中石油中心医院超声科,河北廊坊065000 [4]不详

出　　处：《标记免疫分析与临床》2023年第6期1007-1011,共5页Labeled Immunoassays and Clinical Medicine

基　　金：廊坊市科学技术局科技支撑计划(编号:2021013045)。

摘　　要：目的比较不同HLA-B27基因亚型强直性脊柱炎(ankylosing spondylitis,AS)患者合并心血管疾病风险,进而为临床的个体化精准预防和治疗提供依据。方法选取204例HLA-B27基因阳性AS患者(其中HLA-B2704型99例,HLA-B2705型90例,HLA-B2702型4例,杂合子型11例),以及97例健康体检者,利用Kruskal-Wallis H差异性分析不同基因亚型和健康组间超敏C反应蛋白(hs-CRP)、总胆固醇(TC)、三酰甘油(TG)、脂蛋白a(Lp(a))、载脂蛋白A1(ApoA1)、载脂蛋白B(ApoB)、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)、同型半胱氨酸(Hcy)差异有无统计学意义。同时将所有HLA-B27基因阳性患者作为总体阳性组与健康对照组进行统计学分析,比较以上血清学指标差异有无统计学意义。结果与健康对照组相比,总体阳性组hs-CRP、Hcy、ApoB水平明显较高,ApoA1h和HDL-C水平明显较低,差异有统计学意义(P<0.05);与健康对照组相比,HLA-B2704阳性组hs-CRP、ApoB、Hcy水平明显较高,ApoA1、HDL-C水平明显较低;HLA-B2705阳性组hs-CRP、ApoA1、ApoB、Hcy水平明显较高,LDL-C水平明显较低,差异有统计学意义(P<0.05)。与HLA-B2704阳性组相比,HLA-B2705阳性组ApoA1、HDL-C水平明显较高,ApoB、LDL-C、Hcy水平明显较低,差异有统计学意义(P<0.05)。结论从血液相关指标的对比中可以得出,HLA-B27阳性AS患者患心血管疾病的风险明显增高,其中HLA-B2704亚型患者较其他亚型有更高的心血管疾病风险。Objective The risks of cardiovascular disease in ankylosing spondylitis(AS)patients with different HLA-B27 gene subtype were compared,so as to provide the knowledge basis for clinical individualized precise prevention and treatment.Methods A total of 204 HLA-B27 positive patients with AS(including 99 cases of HLA-B2704,90 cases of HLA-B2705,4 cases of HLA-B2702,and 11 cases of heterozygote)and 97 healthy subjects were selected for the study.Kruskal-wallis H was used to analyze the differences of hypersensitive C-reactive protein(hs-CRP),total cholesterol(TC),triglyceride(TG),lipoprotein a[Lp(a)],apolipoprotein A1(ApoA1),apolipoprotein B(ApoB),high-density lipoprotein(HDL-C),low-density lipoprotein(HDL-C)and homocysteine(Hcy)among different gene subtypes and healthy groups.During the same period,all HLA-B27 gene positive patients were selected as the positive group and the above serological indicators were compared with the healthy group.Results Compared with the healthy control group,levels of hs-CRP,Hcy and ApoB in the overall positive group were significantly higher,while ApoA1h and HDL-C were significantly lower(P<0.05).Compared with the healthy control group,the HLA-B2704 positive group had significantly higher levels of hs-CRP,ApoB and Hcy,and significantly lower levels of ApoA1 and HDL-C.Levels of hs-CRP,ApoA1,ApoB and Hcy in HLA-B2705 positive group were significantly higher,while LDL-C was significantly lower(P<0.05).Compared with the HLA-B2704 positive group,the HLA-B2705 positive group had significantly higher levels of ApoA1 and HDL-C,and significantly lower levels of ApoB,LDL-C and Hcy(P<0.05).Conclusion HLA-B27 positive patients have a significantly increased risk of cardiovascular disease,and patients with HLA-B2704 subtype have a higher risk of cardiovascular disease than other subtypes.

关 键 词：强直性脊柱炎 HLA-B27基因分型 心血管疾病风险 血液学指标 

分 类 号：R593.23[医药卫生—内科学]