目的：了解ＨＬＡＢ２７在强直性脊柱炎（ＡＳ）发病及病情活动中的作用。方法：对比分析５１例ＨＬＡＢ２７阴性〔Ｂ２７（－）〕ＡＳ患者和１０２例病程相同的ＨＬＡＢ２７阳性〔Ｂ２７（＋）〕ＡＳ患者（１∶２配对）的临床表现及实验室检查结果。结果：Ｂ２７（－）组与Ｂ２７（＋）组最明显的差异是前者以女性多见，平均发病年龄偏晚（Ｐ值分别＜００１和００５），且临床上较少出现全身症状、外周关节炎及严重的髋关节病变（Ｐ均＜００５），但合并类风湿关节炎明显多于阳性组（Ｐ＜００１），家族聚集现象、虹膜睫状体炎和脊柱的Ｘ线片改变在两组无差异。病情活动性指标的改变包括血沉和Ｃ反应蛋白的升高在Ｂ２７（－）组明显少于Ｂ２７（＋）组（Ｐ均＜００１）。结论：Ｂ２７（－）ＡＳ患者病情相对较轻，预后较好；Ｂ２７（－）与Ｂ２７（＋）ＡＳ的发病机制可能不尽相同 Objective: To understand the role of HLA  B27 in the pathogenesis and severity of ankylosing spondylitis (AS). Methods: The clinical manifestations and laboratory findings of 51 patients with HLAB27 negative [B27 (-)] AS and 102 patients with identical HLAB27 positive [B27 (+)] AS (matched by 1: 2) . Results: The most obvious difference between B27 (-) group and B27 (+) group was that the former was more common in women and the mean age of onset was later (P <001 and 005, respectively) Symptoms, peripheral arthritis and severe hip joint disease (all P <005), but there were more rheumatoid arthritis patients than the positive group (P <001), familial aggregation, iridocyclitis and spine The X-ray changes did not differ between the two groups. Changes in disease activity indicators, including elevated erythrocyte sedimentation rate and C-reactive protein in the B27 (-) group was significantly less than the B27 (+) group (P <0.01). Conclusions: Patients with B27 (-) AS are relatively mild and have a good prognosis. The pathogenesis of B27 (-) and B27 (+) AS may be different