摘要
目的探讨HLA-B27抗原检测对眼部炎症患者合并强直性脊柱炎(AS)的诊断意义。方法连续收集2012年1月至2015年10月北京同仁医院初发非感染性眼部炎症患者776例,依据发病部位将患者分为葡萄膜炎、巩膜炎、角膜炎和结膜炎四组。检测患者外周血淋巴细胞HLA-B27抗原表达,结合临床资料明确患者是否合并AS。结果 776例患者中149例确诊合并AS,其中葡萄膜炎组130例,巩膜炎组6例,角膜炎组6例,结膜炎组7例。葡萄膜炎组患者的HLA-B27阳性率为25.80%,明显高于巩膜炎组的4.27%、角膜炎组的6.45%和结膜炎组的12.12%,差异均有统计学意义(P<0.05);HLA-B27抗原检测对眼部炎症患者合并AS诊断的灵敏度为94.63%,特异度为98.67%,阳性预测值为95.27%,阴性预测值为98.48%,正确指数为0.93。结论合并AS的眼部炎症患者主要表现为葡萄膜炎,也可表现为结膜炎、角膜炎和巩膜炎等。临床上对初发非感染性眼部炎症患者进行HLA-B27抗原检测,可以辅助诊断其是否合并AS。
Objective To investigate the value of human leukocyte antigen B27（HLA-B27） detection in diagnosis of ophthalmitis complicated with ankylosing spondylitis（AS）. Methods A total of 776 patients newly diagnosed as non-infective ophthalmitis from January 2012 to October 2015 in Beijing Tongren Hospital were collected. The patients were divided into uveitis group, scleritis group, iritis group and conjunctivitis group according to pathogenic sites.They were tested for HLA-B27 expression in peripheral blood lymphocytes in order to identify the combination of AS based on clinical data. Results Among the 776 patients, 149 were diagnosed with AS, including 130 patients in uveitis group, 6 patients in scleritis group, 6 patients in iritis group and 7 patients in conjunctivitis group. HLA-B27 positive rate were 25.80% in uveitis group, which was significantly higher than 4.27% in scleritis group, 6.45% in iritis group and12.12% in conjunctivitis group, with statistically significant differences（P〈0.05）. When HLA-B27 detection was used to diagnose ophthalmitis with AS, the sensitivity, specificity, positive predictive value, negative predictive value and correct index were 94.63%, 98.67%, 95.27%, 98.48%, 0.93. Conclusion Ophthalmitis complicated with AS is primarily manifested as uveitis, but also as conjunctivitis, iritis and scleritis. HLA-B27 detections could be helpful in the auxiliary diagnosis of ophthalmitis complicated with AS.
作者
许晓风
崔莉
毛羽
刘向祎
XU Xiao-feng CUI Li MAO Yu LIU Xiang-yi(Department of Clinical Laborator Department of lmmunology and Rheumatology Beijing Tongren Eye Center , Beijing Tongren Hospital, Capital MedicalUniversity, Beijing 100730, CHINA)
出处
《海南医学》
CAS
2017年第2期237-239,共3页
Hainan Medical Journal
