Clinical Features Observation And Treatment Study Of HLA-B27 Positive Acute Anterior Uveitis

Purpose:To observe and analyze the clinical features of patients with HLA-B27 positive acute anterior uveitis(AAU),and to further explore the treatment progress,in order to better understand the pathogenesis of AAU,guide the future diagnosis and treatment of AAU,save patients'visual acuity,and improve prognosis.Methods:A retrospective study of 118 patients with AAU,divided into HLA-B27 positive group and HLA-B27 negative group was performed.We compared age,gender,diagnosis of previous diseases,whether or not complained with iris adhesion,visual acuity improvement after treatment,erythrocyte sedimentation rate(ESR)and C-reactive protein(CRP).Then we conducted?~2 test or t test,and calculate P value.All data were statistically analyzed using SPSS 19.0 software,with P value<0.05 as an indicator of statistically significant difference.Results:A total of 118 patients were enrolled in the study,including 53 patients with HLA-B27-positive AAU and 65 patients with HLA-B27-negative AAU.1.HLA-B27 positive group,mean age 47.57±14.20 years old,HLA-B27 negative group,mean age 47.08±15.11 years old,after?~2 test,?~2=3.882,P value=0.69,P value>0.05,there was no statistically significant difference.2.Among the HLA-B27 positive group,24 males and 29 females,the ratio of male patients to female patients was 1:1.21;among the HLA-B27 negative patients,30 males and 35 females,the ratio of male patients to female patients was 1:1.17.After?~2 test,?~2=0.009,P value=0.92,P value>0.05,there was no statistically significant difference.3.In the HLA-B27 positive group,8 patients(15.09%)were ankylosing spondylitis,4 patients(7.55%)were rheumatoid arthritis,2 patients(3.77%)were tuberculosis,and 1 patient was gout(1.89%),1 patient was Behcet's disease(1.89%);among the patients with HLA-B27 negative group,5 patients(7.69%)were ankylosing spondylitis,3 patients(4.62%)were rheumatoid arthritis,and 1 patient(1.54%)was tuberculosis,1 patient(1.54%)was psoriasis,and 1 patient(1.54%)was ulcerative colitis.4.Among the HLA-B27 positive group,22 patients had iris adhesion,including 1patient with pupil occlusion,2 patients with secondary glaucoma,and 1 patient with empyema perforation;among the HLA-B27 negative group,15 patients had iris adhesion,including 2 patients with pupil occlusion,3 patients with secondary glaucoma,and 1 patient with with macular edema.After?~2 test,?~2=4.608,P value=0.032,P value<0.05,there was statistically significant difference.5.In the HLA-B27 positive group,there were 11 patients the visual acuity improvement after treatment was<0.1,42 patients?0.1,of which the highest visual acuity improvement was 0.8;in the HLA-B27 negative group,here were 31 patients the visual acuity improvement after treatment was<0.1,34 patients?0.1,of which the highest visual acuity improvement was 0.8.After?~2 test,?~2=9.241,P value=0.002,P value<0.05,there was statistically significant difference.6.In the HLA-B27 positive group,the mean ESR value was 20.50±11.04 mm;in the HLA-B27 negative group,the mean ESR value was 16.13±11.82 mm.After t test,P value=0.021,P value<0.05,there was statistically significant difference.7.In the HLA-B27 positive group,the mean CRP value was 11.65±7.27 mm;in the HLA-B27 negative group,the mean CRP value was 6.63±7.94 mm.After t test,P value=0.0002,P value<0.05,there was statistically significant difference.Conclusion:There was no statistically significant difference in age and gender distribution between HLA-B27 positive AAU patients and HLA-B27 negative group.The most common diagnosis of HLA-B27 positive AAU was ankylosing spondylitis(n=8,15.09%).Compared with HLA-B27 negative group,HLA-B27 positive AAU patients were more prone to iris adhesion,better visual acuity prognosis after treatment,and higher ESR and CRP levels.