| Objective To investigate the distribution of HLA-B27 and its subtypes in patients with spinal arthritis,ankylosing spondylitis and healthy people,and analyze the correlation between different subtypes and disease phenotypes.Methods The HLA-B27 alleles of HLA-B*2704 and HLA-B*2705 in whole blood samples were detected by PCR-SSP and analyzed by SPSS 23.0 software.Result1.The positive rates of HLA-B27 were 76.89%and 8%in the patients with SpAand the healthy control group,respectively.The correlation analysis confirmed that there was a strong correlation between HLA-B27 and SpA(OR=38.3,P=1.940×10-14);the positive rates of HLA-B27 in the AS group and the healthy control group were 88.78%and 8%,respectively.The correlation analysis confirmed that there was a strong correlation between HLA-B27 and AS(OR 90.96,P=1.940×10-15).2.In SpA,the age of onset and the time from onset to diagnosis of HLA-B27 positive patients were significantly lower than that of HLA-B27 negative patients,and the proportion of family history of SpA and the level of IL-6 were significantly higher（P<0.05）.3.HLA-B*2702,HLA-B*2704,HLA-B*2705,HLA-B*2708 and HLA-B*2710were detected in this study.HLA-B*2704 was the most commongene subtype,among which B*2704 and B*2705 were strongly correlated with SpA and AS（or>1）,and HLA-B*2708 was negatively correlatedwith SpA and AS.4.HLA-B*2704 was the most widely distributed subtype of SpA（including AS）,followed by HLA-B*2705.In SpA group,the incidence of digital（toe）inflammation and peripheral arthritis in HLA-B*2705 positive group was significantly higher than that in HLA-B*2704 positive group（P<0.05）.In ASgroup,the proportion of SpA family history and inflammatory back pain in HLA-B*2704 positive group was significantly higher than that in HLA-B*2705positive group（P<0.05）.The proportion of peripheral arthritis and hip joint involvement in HLA-B*2705 positive group was significantly higher than that in HLA-B*2704 positive group（P<0.05）;5.In AS patients,the age of onset was younger,the course of disease was longer,the proportion of initial hip arthritis was higher,the level of IL-6 was higher,the bone density of femoral neck was lower,the HLA-B*2705 gene subtype was the main,and the difference between the two groups was significant（P<0.05）.6.The positive rate of HLA-B*2704 subtype was significantly higher than that of HLA-B*2705 subtype（P<0.05）,while the positive rate of B27 of AS+AAU was significantly higher than that of AAU of other causes（P<0.05）,and there was no significant difference in the distribution of subtypes between AS+AAU group and AAU of other causes.Conclusion1.There is a strong correlation between HLA-B27 and SpA in the Han population of this region,which can be used as an important reference index for the diagnosis of SpA in this region.2.HLA-B*2704 is the main subtype of SpA and AS patients in this region,which is related to SpA and AS.HLA-B*2708 subtype is a rare subtype in this region,which has a negative correlation with SpA and AS,and may be a protective gene subtype in this region.3.Among the patients with SpA（including AS）,the proportion of finger（toe）inflammation,peripheral arthritis and hip joint involvement in the HLA-B*2705positive group was higher,while in the patients with ankylosing spondylitis,the proportion of SpA family history and inflammatory back pain in the HLA-B*2704positive group was higher（P<0.05）;these can be used as indicators for evaluating the condition and judging the prognosis of local SpA patients.4.Patients with AS in the hip joint affected group had a younger onset age,a longer course of disease,a higher proportion of the first hip arthritis,a higher level of IL-6,a lower bone density of the neck of the femur,mainly HLA-B*2705 gene subtype,which should be actively treated in clinical practice to reduce disability. |
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