Saraux A, Guedes C, Allain J, Valls I, Baron D, Youinou P, Le Goff P
Unit of Rheumatology, Brest University Medical School Hospital, France.
Scand J Rheumatol. 1997;26(4):269-71. doi: 10.3109/03009749709105315.
Aims were to determine the prevalence of the HLA-B27 phenotype in a group of patients with RA, and to evaluate the clinical, radiological and, serological characteristics of RA in relation to this phenotype. All relevant information was obtained retrospectively from the standardized clinical records of 311 RA in-patients first admitted to the Rheumatology Unit of the Brest University Medical School. In the control population of Britanny, the frequency of HLA-B27 has been shown to be 12%, while HLA-B27 was present in 30 (9.6%) of the 311 RA patients. There was no significant association between demographic, clinical, biological, or radiological characteristics of the patients on the one hand, and the presence of the HLA-B27 allele on the other. The subgroup of RA patients with HLA-B27 had however a slightly higher IgA level than that without HLA-B27. Ankylosing spondylitis were found to coexist in three patients who all were HLA-B27 positive. We conclude (1) that the prevalence of HLA-B27 is not higher in French RA patients than in the normal controls, and (2) that HLA-B27 typing is not useful in RA. HLA-B27 does not confirm nor does it reject the diagnosis of associated ankylosing spondylitis.
目的是确定一组类风湿关节炎（RA）患者中HLA - B27表型的患病率，并评估与该表型相关的RA的临床、放射学和血清学特征。所有相关信息均从首次入住布雷斯特大学医学院风湿病科的311例RA住院患者的标准化临床记录中回顾性获取。在布列塔尼的对照人群中，HLA - B27的频率已显示为12%，而在311例RA患者中有30例（9.6%）存在HLA - B27。一方面，患者的人口统计学、临床、生物学或放射学特征与另一方面HLA - B27等位基因的存在之间没有显著关联。然而，携带HLA - B27的RA患者亚组的IgA水平略高于不携带HLA - B27的患者。发现3例患者同时存在强直性脊柱炎，且这3例患者均为HLA - B27阳性。我们得出结论：（1）法国RA患者中HLA - B27的患病率并不高于正常对照组；（2）HLA - B27分型对RA无用。HLA - B27既不能证实也不能排除相关强直性脊柱炎的诊断。
