人类白细胞抗原（HLA-B27）在早发和晚发轴性脊柱关节炎患者中的临床意义

IF 1 Q4 RHEUMATOLOGY

Egyptian Rheumatologist Pub Date : 2024-10-18 DOI:10.1016/j.ejr.2024.10.001

Ebru Yilmaz , Özlem Toluk

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引用次数: 0

摘要

工作目的比较早发（EOSpA）和晚发（LOSpA）轴性脊柱关节炎患者中人类白细胞抗原（HLA）-B27阳性患者的临床、实验室和放射学特征。患者和方法该研究纳入了195例HLA-B27阳性的轴性脊柱关节炎患者，分为≤45岁（EOSpA）和45岁（LOSpA）患者。记录患者的特征、接受的药物以及巴斯强直性脊柱炎疾病活动指数（BASDAI）、巴斯强直性脊柱炎功能指数（BASFI）、马斯特里赫特强直性脊柱炎关节炎评分（MASES）、巴斯强直性脊柱炎放射学指数（BASRI）、强直性脊柱炎疾病活动评分（ASDAS）。肩痛、外周关节炎和粘连性关节囊炎在 LOSpA 中明显更常见（20%、13.7% 和 5.3%；p = 0.001、p = 0.017 和 p = 0.026），而背痛和腰痛在 EOSpA 中明显更突出（20% 和 61%；p = 0.011 和 p = 0.001）。两组患者在性别、体重指数（BMI）、吸烟、抗肿瘤坏死因子（TNF）-α 的使用、C 反应蛋白（CRP）、BASFI、BASDAI、ASDAS、MASES 和 BASRI 评分方面存在明显差异（p < 0.001，p < 0.001，p = 0.016，p < 0.001，p < 0.001，p = 0.009，p < 0.001，p = 0.018，p < 0.001，p < 0.001）。回归分析显示，男性性别和高 CRP 与 EOSpA 相关（p = 0.011 和 p = 0.001），而早期骶髂关节炎、使用非甾体抗炎药（NSAID）、高 BASFI 和 BASRI 与 LOSpA 相关（p = 0.004、p = 0.003、p < 0.结论LOSpA与女性性别、外周受累、较低的炎症标志物水平、较高的功能状态和疾病活动度、较高的关节炎和放射学评分以及较少使用抗肿瘤坏死因子-α有关。

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Clinical signficance of human leucocytic antigen (HLA-B27) in patients with early and late-onset axial spondyloarthritis

Aim of the work

To compare the clinical, laboratory and radiological features of patients with positive human leucocytic antigen (HLA)-B27 in patients with early-onset (EOSpA) and late-onset (LOSpA) axial spondyloarthritis.

Patients and methods

The study included 195 axial-SpA patients with positive HLA-B27 divided into those ≤45 years (EOSpA) and those >45 years (LOSpA). Characteristics of the patients, medications received as well as Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), Maastricht Ankylosing Spondylitis Enthesitis Score (MASES), Bath Ankylosing Spondylitis Radiological Index (BASRI), Ankylosing Spondylitis Disease Activity Score (ASDAS) scores were recorded.

Results

The mean age of the patients was 43.6 ± 13.3 years and 121 (62.1 %) were females. Shoulder pain, peripheral arthritis, and adhesive capsulitis were significantly more common in LOSpA (20 %,13.7 % and 5.3 %; p = 0.001, p = 0.017, and p = 0.026) whereas dorsal and low back pain were significantly more prominent in EOSpA (20 % and 61 %; p = 0.011 and p = 0.001). There was a significant difference between the two groups in terms of gender, body mass index (BMI), smoking, anti-tumor necrosis factor (TNF)-α use, C-reactive protein (CRP), BASFI, BASDAI, ASDAS, MASES and BASRI scores (p < 0.001, p < 0.001, p = 0.016, p < 0.001, p < 0.001, p = 0.009, p < 0.001, p = 0.018, p < 0.001, p < 0.001, respectively). On regression analysis, male gender and high CRP were associated with EOSpA (p = 0.011, and p = 0.001), while early-stage sacroiliitis, non-steroidal anti-inflammatory drug (NSAID) use, high BASFI and BASRI were related to LOSpA (p = 0.004, p = 0.003, p < 0.0001 and p < 0.0001).

Conclusion

LOSpA was associated with female gender, peripheral involvement, lower levels of inflammatory markers, higher functional status and disease activity, higher enthesitis and radiological scores, and less use of anti-TNF-α.

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来源期刊

Egyptian Rheumatologist RHEUMATOLOGY-

CiteScore

2.00

自引率

22.20%

发文量

审稿时长

39 weeks