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目的:探讨骨代谢指标和人类白细胞抗原B27(HLA-B27)在检测强直性脊柱炎(AS)患者的临床意义,并分析其诊断价值。方法:研究对象为94例AS患者、239例其他病种对照和80例健康对照组,并对其结果进行回顾性分析。结果:AS组β-胶原特殊序列(β-CTX)高于对照组,而骨钙素(OC)、25羟基维生素D[25-(OH)D]和甲状旁腺素(PTH)低于对照组(P<0.05);AS组C反应蛋白(CRP)和β-CTX呈明显的正相关(P<0.01),25-(OH)D呈负相关(P<0.05),其他骨代谢指标和CRP无相关性;AS组HLA-B27阳性率明显高于其他组(P<0.05),且HLA-B27在诊断AS时具有很高的敏感性和特异性;AS组25-(OH)D检测的敏感性高于β-CTX,但特异性低于β-CTX。结论:骨代谢指标对AS早期筛查,临床诊断有着重要价值,尤其是β-CTX和25-(OH)D的诊断价值更为明显。
Objective: To investigate the clinical significance of bone metabolism index and human leukocyte antigen B27 (HLA-B27) in the detection of ankylosing spondylitis (AS) and to analyze its diagnostic value. Methods: The subjects were 94 AS patients, 239 other disease control cases and 80 healthy controls, and the results were retrospectively analyzed. RESULTS: The β-CTX in AS group was higher than that in control group, while the levels of osteocalcin (OC), 25-hydroxyvitamin D [25- (OH) D] and parathyroid hormone (PTH) (P <0.05). CRP and β-CTX showed a significant positive correlation (P <0.01), while 25- (OH) D showed a negative correlation (P <0.05) The positive rate of HLA-B27 in AS group was significantly higher than that in other groups (P <0.05), and HLA-B27 was highly sensitive and specific in the diagnosis of AS. The 25- (OH) D Is more sensitive than β-CTX but less specific than β-CTX. Conclusion: The indexes of bone metabolism have important value in the early screening and clinical diagnosis of AS. Especially, the diagnostic value of β-CTX and 25- (OH) D is more obvious.