甘肃地区汉族人HLA—DR4基因检测与进展性类风湿性关节炎的关系

目的：探讨HLA—DR4基因与进展性类风湿性关节炎（RA）临床特征的关系。方法：记录73例类风湿关节病例的临床资料和相关实验室检查结果及HLA—DR4基因携带情况，并比较HLA—DR4阳性组与阴性组的临床表现、实验室指标、X线表现及功能分级。结果：HLA—DR4阳性27例，基因频率为37％，阴性46例。HLA—DR4阳性组关节肿胀指数、疼痛指数较高，晨僵持续时间较长，关节功能分级为Ⅲ～Ⅳ级的比例较高，出现骨质破坏比例也较高；HLA—DR4阳性组的ESR、CRP和RF，抗CCP抗体值高于阴性组。结论：甘肃地区汉族人RA患者的HLA—DR4阳性率与国内其他地区汉族人RA患者的阳性率较为接近。HLA—DR4阳性组的RA患者的病情相对较HLA—DR4阴性组的RA病例炎症活动严重，且进展较快，应积极联合治疗。

The relationship between HLA -DR4 gene and progressive rheumatoid arthritis in Han people of Gansu province

Objective： To explore the relationship between the genes of human leukocyte antigens （HLA） - DR4 and the clinical characteristics in the progressive rheumatoid arthritis （RA）. Methods： We collected clinical data and related laboratory results and HLA - DR4 gene with cytotoxicity assay of 73 patients with rheumatoid arthritis, and compared clinical manifestations, laboratory results, X -ray manifestations and joint functional classification between HLA - DR4 positive group and negative group. Results： Twenty - seven cases was HLA - DR4 positive result, the gene frequency was 37%, and 46 cases were HLA - DR4 negative result. There was the higher index of joint swelling and pain, the longer duration of mornig stiffness, the higher proportion of bone destruction and joint function Ⅲ - Ⅳ grade level in HLA - DR4 positive result. The value of ESR, CRP, RF and anti - CCP antibody in HLA - DR4 positive group was higher than that of negative group. Conclusion： RA patient with the HLA - DR4 positive rate of Han people in Gansu Province was more close to other regions in mainland China. Compared with HLA - DR4 negative group, there are severe inflammatory activity, rapid disease progress in HLA - DR4 positive group in which combined treatment should be done.