類風濕性關節炎的組織抗原分析

Association of HLA Antigens and Rheumatoid Arthritis

吾等收集了六十例類風濕性關節炎患者及六十三例正常成人為對照組，詳查其組織抗原(HLA-A, B, C, DR)的分佈情形。並將病患再細分為類風濕因子陽性者（50位），類風濕因子陰性者（10位），抗核抗體陽性者（30位），早期發病者（22位），有家族性者（5位）及有皮下結節者（4位），來跟正常人做比較。吾等發現(1)病患具有HLA- DR4者佔35％，略高於正常人的27％，但並未達統計學上的差別薏義(2)HLA- B16, -BW46, -CW1在類風濕因子陽性者呈有意義地增加，(P< 0.05)而其HLA- B17卻顯著地減少(P <0.01)(3)HLA- DR2在類風濕因子陰性者或類風濕因子陽性但其效價小於640者，及抗核抗體陽性者呈現有意義之關連(P< 0.05)(4)有家族歷或皮下結節者容易出現HLA- DRW9(P< 0.05)，而早期發病者並沒有特別關連的HLA- DR抗原。

Sixty Chinese patients with classic and definite rheumatoid arthritis (RA) were studied for HLA- A, -B, -C and -DR locus alloantigens. The prevalence of DR4 was increased in our series, but it did not attain a level of statistical significance. Unexpectedly, HLA-B16, Bw46 and Cwl were found to be significantly associated in seropositive RA patients. Patients negative for the rheumatoid factor, those who were weakly seropositive, and those positive for the anti-nuclear antibody were closely related with DR2, The patients with positive family history and/ or subcutaneous nodules frequently possessed HLA-DRw9 antigen. There was no specific association between HLA-DR antigens and patients with early onset of illness.