各種HLA-B27亞型在僵直性脊椎炎病人之中的盛行率

The prevalence of HLA-B27 subtypes in AS patients

前言：僵直性脊椎炎是一種HLA-B27相關之脊椎關節病變，大多數的病患帶有HLA-B27基因型，然而所有HLA-B27陽性的人當中，只有小部份的人會成為僵直性脊椎炎患者。本文述說出我們試圖藉由HLA-B27亞型的分析，來預測臺灣的各種HLA-B27亞型之脊椎關節病變患者當中是僵直性脊椎炎的可能性。材料與方法：我們從門診採集了251位HLA-B27相關之脊椎關節病變患者的血液來分析，其中總計有197個僵直性脊椎炎的病例和54個非僵直性脊椎炎的病例，利用PCR-SSOP的標準方法來檢定他們的HLA-B27亞型。結果：從我們的病人當中，總共發現了四種HLA-B27的基因型。在197個僵直性脊椎炎的病人中，有191位僵直性脊椎炎的病人帶有B*2704基因型，有4位是B*2705基因型以及2位是B*2706基因型。在54位非僵直性脊椎炎的病人中，有47位是B*2704基因型，另5位帶有B*2705基因型，一位是B*2706基因型和一位是B*2707基因型。我們的結果顯示出這群脊椎關節病變的病人當中，B*2704基因型與僵直性脊椎炎有較強烈的關係，而B*2705基因型則與非僵直性脊椎炎有較強烈的關係。結論：以我們這群台灣病患所作的統計結果顯示，用分析HLA-B27亞型的方法來預測僵直性脊椎炎，就台灣的脊椎關節病變患者而言，其效益是有限的。

Background: Ankylosing spondylitis (AS) is an HLA-827-related spondyloarthropathy (SpA). Most AS patients carry the HLA-827 genotype, but only a small fraction ofHLA-827 positive people develop AS. This article describes our attempt to predict the probability of AS in Taiwanese SpA patients who have different HLA-B27 subtypes. Methods: We obtained blood specimens from 251 outpatients suffering from HLA-827-related SpA. There were 197 AS cases and 54 non-AS cases. We used a standard method PCR-SSOP to determine HLA-827 subtypes. Results: We found 4 HLA-827 genotypes among our patients. Among the 197 AS patients, 191 had the 8*2704 genotype, 4 had the B*2705 genotype, and 2 had the B*2706 genotype. Among the 54 non-AS patients, 47 had the B*2704 genotype, 5 had the 8*2705 genotype, I had the 8*2706 genotype, and I had the B*2707 genotype. Among our SpA patients, our results indicate a stronger association of the 8*2704 genotype with AS, and a stronger association of the 8*2705 genotype with the absence of AS. Conclusion: The results with our population of Taiwanese patients indicate limited usefulness of HLA-B27 subtyping for prediction AS in SpA patients from Taiwan.