流式细胞术检测HLA―B27对辅助诊断AS作用评估.docVIP

流式细胞术检测HLA―B27对辅助诊断AS作用评估 　　【摘要】 目的 评估流式细胞术HLA-B27检测对强直性脊柱炎（AS）的临床诊断价值。方法 对438例均经过X线检查的患者用流式细胞仪法进行HLA-B27检测， 计算各项诊断性能指标， 并与X线检查结果进行比较分析。结果 流式细胞术HLA-B27检测试验的灵敏度、特异性、准确度和约登指数分别为89.3%、93.1%、91.3%、0.824。两种诊断方法差异无统计学意义（P=0.4240.05）， 而且吻合度较好（к=0.8850.7）。另外有7例（3.5%）AS患者X线检查正常而HLA-B27阳性。结论 流式细胞术HLA-B27检测对AS的诊断价值较高， 适合于临床常规检测。 　　【关键词】 流式细胞仪；HLA-B27；强直性脊柱炎；X线检查 　　DOI：10.14163/j.cnki.11-5547/r.2015.11.008 　　Evaluation of HLA-B27 detection by flow-cytometry for effect of assisted diagnosis of AS ZHANG Jing， HE Qi-rui， JIN Yu-lin， et al. Department of Blood Transfusion， Xinyang City Central Hospital， Xinyang 464000， China 　　【Abstract】 Objective To evaluate the clinical diagnosis value of HLA-B27 detection by flow-cytometry for ankylosing spondylitis （AS）. Methods Flow-cytometry was applied for 438 patients under X-ray examination to detect their HLA-B27. Indicators of diagnostic performance were calculated， and were compared with X-ray examination outcomes. Results The sensitivity， specificity， accuracy， and Youden index of flow-cytometry in detection of HLA-B27 were respectively 89.3%， 93.1%， 91.3%， and 0.824. There was no statistically significant difference between these two diagnosis methods （P=0.4240.05）， and both methods had good coincidence rate （к=0.8850.7）. There were another 7 cases （3.5%） with AS had normal result in X-ray examination along with positive HLA-B27. Conclusion Flow-cytometry provides high diagnostic value for AS through its detection of HLA-B27， and it is worth being applied in clinically conventional detection. 　　【Key words】 Flow-cytometry； HLA-B27； Ankylosing spondylitis； X-ray examination 　　HLA-B27基因是HLA-Ⅰ类分子B位点上一个重要的等位基因， 位于人类第6号染色体短臂上。该基因编码的抗原几乎表达在所有有核细胞上， 尤其淋巴细胞表面含量最为丰富。HLA-B27分子的免疫功能主要有负责细胞之间的相互识别， 诱导免疫反应和调节免疫应答等。早在1973年Brewerton等就发现HLA-B27表达与AS关系密切[1]。后来的研究证实：HLA-B27抗原表达与AS呈高度相关性， 超过90% AS患者HLA-B27抗原阳性[2-4]， 而正常人群HLA-B27阳性率只有5%左右。迄今为止， 在发现的所有HLA抗原与疾病关联中， HLA-B27与AS的相关性最强最典型[5]。因此， HLA-B27检测对AS的临床诊断和鉴别诊断具有重要意义。本院在2007年开展了HLA-B27流式细胞术检测技术，