目的 探讨流式法检测人类白细胞抗原B27/B7(HLA-B27/B7)在临床上对强直性脊柱炎(AS)的诊断价值.方法 采用两色流式细胞术检测121例AS患者(AS组)、157例其他原因引起的腰腿痛患者(非AS组)和88例健康人(对照组)淋巴细胞HLA-B27及HLA-B7抗原的表达率及表达强度(MnX).结果 AS组HLA-B27表达率、MnX和阳性率分别为(90.55±25.31)%、(16.87±9.13)%、90.9%,明显高于非AS组及对照组(P<0.05);非AS组上述各项指标与对照组相比差异无统计学意义(P>0.05).将流式细胞法检测HLA-B27表达率、MnX及2项指标联合分别用于临床AS的诊断,灵敏度依次为90.9%、94.2%、98.3%,特异度依次为89.8%、84.5%、83.7%,卡方检验显示,联合检测时灵敏度显著高于单独检测表达率(P<0.05),且特异度差异无统计学意义(P>0.05).结论 流式细胞法检测HLA-B27对AS的诊断和鉴别诊断准确、有效,是一种很有价值的实验诊断方法.%Objective To analyze of the diagnostic value of detection of HLA-B27/B7 by flow cytometry for ankylosing spondy-litis(AS). Methods Flow cytometry was used to determine the fluorecence positive percentage and mean fluorecence of HLA-B27/ B7 in lymphocytes in 121 patients with AS (AS group) ,157 backleg pain patients without AS(non-AS group) ,and 88 health con-trols(control group),and results were analyzed statistically. Results Fluorecence positive percentage, mean fluorescence and positive percentage of HLA-B27 in AS group were (90. 55 + 25. 31) %, (16. 87 + 9. 13) % ,90. 9% respectively, which were significantly higher than those in non-AS group and control group(P<0. 05). No significantly difference between non-AS group and controls were demonstrated in the results. Fluorecence positive percentage,mean fluorescence and both of them,detected by flow cytometry, were with the diagnostic sensitivity of 90. 9%, 94. 2% and 98. 3% , specificity of 89. 8%, 84. 5% and 83. 7%. The sensitivity of combined detection was significantly higher than of single fluorecence positive percentage detection (P<0. 05) , and the specificity was close(P>0. 05) by Chi-Square test. Conclusion The determination of HLA-B27 by flow cytometry could be an accurate and effective method for the diagnosis and differential diagnosis of AS.
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