摘要
目的探讨HLA-B27的阳性强弱对血清阴性脊柱关节病(SPA)诸病种的诊治影响评估。方法 78例SPA(血清阴性脊柱关节病)中AS(强直性脊柱炎)32例,USPA(未分化脊柱关节病)42例,PSA 3例,ReA1例,计HLA-B27强阳性4例,阳性30例,弱阳性40例,阴性4例。结果随访2～20年,1例HLA-B27强阳性AS患者不遵医嘱治疗,6年后两髋关节损害致残,其他3例HLA-B27强阳性患者急性发作多次,但病情控制较好,30例HLA-B27阳性患者中3例失访,其他按正规抗AS治疗,病情平稳其中男性28例。40例HLA-B27弱阳性患者中有2例在1～4年后被确诊为AS,1例被诊断反应性关节炎,且女性有29例,其他病情平稳,HLA-B27阴性4例,行抗AS治疗,骶髂关节炎在Ⅰ～Ⅱ级之间未进一步发展。结论 HLA-B27强阳性及阳性SPA多见于男性,病情发展快,难以控制病情,HLA-B27强阳性SPA患者致残率高,HLA-B27弱阳性的SPA、USPA患者多见于女性,症状一般较轻,易于控制。HLA-B27阴性SPA患者更较少见,病情发展慢,且易于控制发展。
Objective To explore the impact of HLA-B27 positive strength on the diagnosis and treatment of various diseases of seronegative spondyloarthropathies（SPA）.Methods In the 78 SPA（seronegative spondyloarthropathy disease） patients,AS（ankylosing spondylitis）32 cases,USPA（undifferentiated spondyloarthropathy）42 cases,PSA 3 cases,ReA 1 case,taking into account the strongly positive for HLA-B27 4 cases,positive 30 cases,weakly positive 40 cases,negative 4 cases.Results The patients were followed up for 2 to 20 years,one strong HLA-B27 positive AS patient did not obey doctors’ advice,bilateral hip disability after 6 years,the other three HLA-B27 strongly positive patients had acute exacerbation,but the disease was well control,3 patients with HLA-B27-positive were lost to follow.Other patients received a formal anti-AS treatment and in stable condition.There were 28 males in stable condition.Of 40 patients with HLA-B27 weakly positive,two cases were diagnosed as AS after 1 to 4 years.1 case was diagnosed as reactive arthritis,female 29 cases,other patients in stable condition.4 cases with HLA-B27 negative received a formal anti-AS treatment,and sacroiliitis was not further development between grade Ⅰ ～ Ⅱ.Conclusion Strongly positive in HLA-B27 and positive SPA is more common in men,rapid progression of the disease,difficult to control the disease,strong positive HLA-B27 SPA patients with high morbidity.Weakly positive HLA-B27 SPA,USPA patients are more common in women,the symptoms are generally mild,easy to control.HLA-B27 negative SPA patients are rare,the progression of the disease slow,and easy to control.
出处
《颈腰痛杂志》
2013年第4期333-335,共3页
The Journal of Cervicodynia and Lumbodynia
