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HLA-B27阳性和阴性的轴性脊柱关节炎患者临床特征比较:来自4131例患者队列的结果

Comparison of Clinical Features in HLA-B27 Positive and Negative Patients With Axial Spondyloarthritis: Results From a Cohort of 4,131 Patients.

作者信息

Zhang Shangzhu, Wang Yanhong, Peng Linyi, Su Jinmei, Zeng Xiaofeng, Li Mengtao, Wu Zhenbiao, Xu Jian, Yang Min, Wu Lijun, Zhao Cheng, Duan Xinwang, Li Qin, Zhu Jing, Fan Wenqiang

机构信息

Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Ministry of Science and Technology, Department of Rheumatology, National Clinical Research Center for Dermatologic and Immunologic Diseases, Peking Union Medical College, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.

Department of Epidemiology and Bio-Statistics (YW), Peking Union Medical College, Institute of Basic Medical Sciences, China Academy of Medical Sciences, Beijing, China.

出版信息

Front Med (Lausanne). 2020 Dec 23;7:609562. doi: 10.3389/fmed.2020.609562. eCollection 2020.

Abstract

The aim of our study was to assess the influence of the HLA-B27 status on axial spondyloarthritis (axSpA) in the largest cohort in China. An observational, cross-sectional, and analytic study of axSpA patients from the China axSpA database was performed. Demographic and clinical data were compared in terms of the HLA-B27 status. Univariate and multivariate analyses were performed to identify variables related to HLA-B27 presence. We enrolled 4,131 patients in this study; of those, 36,95 (89.4%) were HLA-B27 positive. In the multivariate analysis, male gender ( < 0.001), younger age ( < 0.001), a disease duration of more than 3 years ( < 0.001), a family history of SpA ( < 0.001), uveitis ( < 0.001), ASDAS-CRP ( < 0.001), and biologic treatment ( < 0.001) were the main variables that were independently related to HLA-B27 presence, whereas a diagnosis delay time >36 months ( < 0.001) and psoriasis ( < 0.001) were independently related to HLA-B27 absence. In Chinese axial SpA patients, presence of HLA-B27 is associated with the male sex, younger age, longer disease duration, greater family aggregation, and higher frequency of uveitis; absence of HLA-B27 is associated with longer diagnosis delay time and higher frequency of psoriasis.

摘要

我们研究的目的是在中国最大的队列中评估HLA - B27状态对轴性脊柱关节炎(axSpA)的影响。对来自中国axSpA数据库的axSpA患者进行了一项观察性、横断面分析研究。根据HLA - B27状态比较人口统计学和临床数据。进行单因素和多因素分析以确定与HLA - B27存在相关的变量。本研究共纳入4131例患者,其中3695例(89.4%)HLA - B27阳性。在多因素分析中,男性(<0.001)、年龄较小(<0.001)、病程超过3年(<0.001)、SpA家族史(<0.001)、葡萄膜炎(<0.001)、ASDAS - CRP(<0.001)和生物治疗(<0.001)是与HLA - B27存在独立相关的主要变量,而诊断延迟时间>36个月(<0.001)和银屑病(<0.001)与HLA - B27缺失独立相关。在中国轴性SpA患者中,HLA - B27阳性与男性、年龄较小、病程较长、家族聚集性较高以及葡萄膜炎发生率较高相关;HLA - B27阴性与诊断延迟时间较长和银屑病发生率较高相关。

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