A multicentre study of clinical features and HLA typing in Japanese patients with ankylosing spondylitis
A multicentre study of clinical features and HLA typing in Japanese patients with ankylosing spondylitis
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DOI：
10.1093/mr/roac008
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发表时间：
2022-02-05
影响因子：
2.2
通讯作者：
Tamura, Naoto
中科院分区：
文献类型：
--
作者：
Tada, Kurisu;Dobashi, Hiroaki;Tamura, Naoto
目的由于人类白细胞抗原B27和强直性脊柱炎(AS)在日本的发病率较低，风湿科医生对AS的治疗经验很少。我们进行了一项多中心研究，以确定人类白细胞抗原B亚型的特征和频率。方法对日本强直性脊柱炎患者的流行病学和临床资料、血检、脊柱X线片和人类白细胞抗原B亚型进行分析。结果我们评估了111例AS患者，其中以男性为主(82.9%)。平均年龄43.7岁，起病24.2岁，确诊36.0岁，发病至确诊时间11.6年。炎性腰痛96例(86.5%)，外周关节炎59例(53.2%)，脊柱炎35例(31.5%)，指炎6例(5.4%)。关节外症状包括葡萄膜炎41例(36.9%)，牛皮癣1例(0.9%)，炎症性肠病5例(4.5%)。HLAB27阳性83例(74.8%，优势比1146.0)，HLAB48阳性9例(8.1%，优势比3.0)。HLA-B27阳性患者发病年龄较小，诊断延迟时间较短。结论除银屑病低并存外，其临床症状与其他国家基本相同。日本患者的HLA-B27阳性率为78%。HLA-B27阳性患者年龄较小，诊断较早。除与人类白细胞抗原B27有关外，还提示与人类白细胞抗原B48有关。
Objectives Due to the low prevalence of HLA-B27 and ankylosing spondylitis (AS) in Japan, rheumatologists have little experience with AS. We conducted a multicentre study to identify the characteristics and frequency of HLA-B types. Methods We analysed epidemiological and clinical data, blood tests, spine radiographs, and HLA-B types in Japanese AS patients. Results We evaluated 111 AS patients, predominantly men (82.9%). The mean age, disease onset, diagnosis, and time from onset to diagnosis were 43.7, 24.2, 36.0, and 11.6 years, respectively. Inflammatory low back pain was found in 96 cases (86.5%); peripheral arthritis in 59 (53.2%), enthesitis in 35 (31.5%), and dactylitis in 6 (5.4%). Extra-articular symptoms included uveitis, psoriasis, and inflammatory bowel disease in 41 (36.9%), 1 (0.9%), and 5 (4.5%) cases, respectively. HLA-B27 was positive in 83 cases (74.8%; odds ratio, 1146.0); and HLA-B48 in 9 (8.1%; odds ratio, 3.0). HLA-B27-positive patients were younger at onset and had a shorter diagnostic delay. Conclusions AS clinical symptoms were almost the same as other countries except for the low coexistence of psoriasis. HLA-B27 positivity in Japanese patients was 78%. HLA-B27-positive patients were younger and diagnosed earlier. In addition to HLA-B27, a relationship with HLA-B48 was suggested.