摘要
[目的]提高对HLA-B27阴性强直性脊柱炎的认识。[方法]回顾我院风湿免疫科诊断为HLA-B27阴性强直性脊柱炎的患者17例和HLA-B27阳性强直性脊柱炎的患者69例,分析两者在临床表现、实验室检查、影像学改变及治疗方面的差异。[结果]HLA-B27阴性者以女性多见,平均发病年龄偏晚,关节功能差,外周关节受累比阳性组更为突出。放射学改变和对治疗的反应上,阳性、阴性两组比较无区别。[结论]HLA-B27阳性在强直性脊柱炎的诊断上既非必要也非充分条件,对临床上怀疑强直性脊柱炎的患者,特别是对年龄较大,关节功能良好,以外周关节疼痛为主,或女性患者,无论HLA-B27是否阳性尽早放射学检查是关键,以避免误诊和漏诊。
[Objective] To improve the recognition to HLA-B27 negative AS.[Method] To such negative patients 17 cases and positive patients 69 cases,analyse their clinical demonstration,lab tests,imageological change and treatment difference.[Result] The HLA-B27 negative ones were mostly female,with elder attack ages and low degree of disease activity;on radiology change and reaction on treatment,both had no difference.[Conclusion] Positive HLA-B27 is not necessary or enough condition for diagnosing AS;to clinical patients suspect of AS,esp.those with elder age,good joint function,mainly with peripheral joint pain,or of female,no matter it’s positive or negative HLA-B27,the radiology exam shall be made sooner,to avoid misdiagnosis or missed diagnosis.
出处
《浙江中医药大学学报》
CAS
2013年第6期704-705,716,共3页
Journal of Zhejiang Chinese Medical University
