流式细胞术检测HLA-B27诊断强直性脊柱炎临界值设置的探讨分析

目的 应用流式细胞术检测外周血白细胞HLA-B27,并结合临床诊断,寻求诊断强直性脊柱炎（Ankylosing spondylitis,AS）的最适合临界值.方法 应用美国Beeton Dickinson公司流式细胞仪检测95例AS患者、226例非AS（包括腰腿背痛患者87例,其他SPA患者62例,类风湿性关节炎43例,风湿性关节炎34例）患者及50例健康体检者的外周血HIA-B27表达强度.结果 以美国BD公司试剂设定的界值≥荧光强度147道数为准,仅58例AS患者（61.05%）HLA-B27阳性,其中有17例检测值在140-146道数之间;非AS组中,HLA-B27阳性11例（4.87%）;健康对照组HLA-B27阳性3例（6.00%）.结论 以进口试剂盒设置的临界值为准,AS组阳性率过低,与临床不符,影响一部分AS患者的早期诊断.如降低其临界值,提高流式细胞术检测HLA-B27抗原的阳性率,更符合临床诊断,有利于AS患者的诊断和治疗.

The critical value setting discussion analysis of flow cytometer detecting HLA-B27 for diagnosing ankylosing spondylitis

Objective The flow eytometer assay was used to investigate the express levels of HLA- B27 in patients with ankylosing spondylitis（AS）, and according to tile clinical diagnosis, to discuss the clinical signification of the setting of clinical value to the diagnosis of AS. Methods Flow cytometer from American BD company was used to test the express levels of HLA- B27 from 95 patients with AS, 226 non - AS patients, and 50 healthy control. Results According to the critical value of BD（ ~ 147）, there were only 58 positive cases（61.05 % ）in AS group,and there were 17 AS patients whose HI_,A - B27 levels were between 140 and 146,there were 11 positive case（4.87 % ）in non - AS group, and there were 3 positive case（6.00 % ）in healthy group. Conclusion The positive rate in AS group was too low, which didn＇t correspond to the clinical diagnosis .The critical value of importing reagent box was so high that a large amount of padents were let off. If We lower the criti- cal value, the positive rate of HLA- B27 with flow cytometer could be raised, and flow cytometer could be more useful to the clinical diagnosis and differential diagnosis.