Paimela L, Leirisalo-Repo M, Helve T, Koskimies S
Department of Rheumatology, Kivelä Hospital, Helsinki, Finland.
Scand J Rheumatol. 1993;22(5):220-4. doi: 10.3109/03009749309095126.
The prognostic significance of HLA DR4 and B27 antigens was investigated in a 3-year follow-up of 87 patients with early rheumatoid arthritis (RA). The frequencies of DR1, DR4 and also of B27 were increased and the frequencies of DR2, DR3 and DR7 decreased compared with the normal Finnish population. During the follow-up with antirheumatic treatment, a similar improvement in clinical variables and laboratory measure assessing disease activity was found in both DR4-positive and DR4-negative RA patients. Despite clinical improvement a fast radiological progression in peripheral joints was observed but the presence of DR4 or B27 had no impact on the progression of joint damage. In some patients cervical changes developed early in the course of RA but were not related to DR4 or B27 positivity. The earlier observation of increased prevalence of HLA B27 in the Finnish RA patients was confirmed but the presence of B27 did not modify the clinical picture of RA.
在对87例早期类风湿性关节炎（RA）患者进行的3年随访中，研究了HLA DR4和B27抗原的预后意义。与正常芬兰人群相比，DR1、DR4以及B27的频率升高，而DR2、DR3和DR7的频率降低。在抗风湿治疗的随访期间，DR4阳性和DR4阴性的RA患者在评估疾病活动的临床变量和实验室指标方面都有类似的改善。尽管临床症状有所改善，但在外周关节观察到快速的放射学进展，而DR4或B27的存在对关节损伤的进展没有影响。在一些患者中，颈椎改变在RA病程早期出现，但与DR4或B27阳性无关。芬兰RA患者中HLA B27患病率增加这一较早的观察结果得到了证实，但B27的存在并未改变RA的临床表现。
