江西地区强直性脊柱炎与HLA - B27基因关联性

目的：调查分析江西地区 HLA - B27基因与强直性脊柱炎的关联性，探讨其对强直性脊柱炎的诊断意义。方法：选择2007-10 /2008-12 在南昌大学第一附属医院收治的疑似强直性脊柱炎及其相关疾病的患者1 246例。其中323 例诊断为强直性脊柱炎，923 例为类风湿关节炎等相关疾病患者。另外选取135例完全健康者作为对照组。采用序列特异性引物-聚合酶链方法(PCR-SSP法)，对1 246例临床疑似强直性脊柱炎患者及135例健康者进行HLA-B27基因检测。观察患者HLA-B27的分布情况，HLA-B27与年龄的关系，以及强直性脊柱炎与 HLA-B27之间的关系。结果：1246例疑似强直性脊柱炎患者的HLA-B27总阳性率32.5% ；135例健康者的阳性率为3.7%；323例强直性脊柱炎患者的阳性率为91.6%。男性的阳性率及发病率均高于女性(P < 0.01)，且发病年龄主要集中在青少年时期。强直性脊柱炎患者HLA-B27抗原的敏感性为91.64%,，特异性为88.19%。结论：HLA-B27 基因与强直性脊柱炎呈高度相关性，江西地区强直性脊柱炎与HLA-B27的关联性与文献报道的其他地区基本一致，检测HLA-B27基因对强直性脊柱炎的早期诊断和鉴别诊断具有重要意义。

Association between ankylosing spondylitis and HLA-B27 gene in Jiangxi province

OBJECTIVE: To study the relevance between HLA-B27 gene and ankylosing spondylitis in Jiangxi province, and to discuss the diagnostic significance to ankylosing spondylitis.METHODS: A total of 1 246 patients with suspected ankylosing spondylitis and related diseases were collected from the First Affiliated Hospital of Nanchang University from October 2007 to December 2008. Among all cases, 323 were diagnosed as ankylosing spondylitis, and other 923 were rheumatoid arthritis or related diseases. A total of 135 healthy subjects were collected as control group. Sequence-specific primer - polymerase chain method (PCR-SSP) was used to detect HLA-B27 gene in 1 246 patients and 135 healthy controls. The distribution of HLA-B27 gene, correlation between HLA-B27 gene and age, and relation between ankylosing spondylitis and HLA-B27 gene were studied. RESULTS: Total positive rate of HLA-B27 gene was 32.5% in 1 246 patients with suspected ankylosing spondylitis, 3.7% in 135 healthy controls, and 91.6% in 323 patients with ankylosing spondylitis, respectively. The positive rate and incidence rates of male were significantly higher than female (P < 0.01) and mainly concentrated in the age of adolescence. The sensitivity of HLA-B27 gene was 91.64% and the specificity was 88.19% in patients with ankylosing spondylitis.CONCLUSION: HLA-B27 gene was highly correlated with ankylosing spondylitis in Jiangxi province, which was the same as other regions, suggesting that HLA-B27 gene is significance for diagnosis of ankylosing spondylitis in an early phase.