HLA-B<sup>*</sup>27亚型双阳性的脊柱关节炎2例报道并文献复习

黄跃; 钱璐辛; 徐聪颖; 姚麟; 李涯松

doi:10.16766/j.cnki.issn.1674-4152.004474

HLA-B^*27亚型双阳性的脊柱关节炎2例报道并文献复习

doi: 10.16766/j.cnki.issn.1674-4152.004474

黄跃^{1, 2},
钱璐辛^{1, 2},
徐聪颖¹,
姚麟^{1, 2},
李涯松^1, ,

1.
浙江省人民医院/杭州医学院附属人民医院风湿免疫科, 浙江杭州 310014
2.
浙江中医药大学第二临床学院浙江杭州 310053

基金项目:

国家中医药管理局-浙江省中医药管理局共建重点项目 GZY-ZJ-KJ-23047

详细信息

通讯作者:
李涯松，E-mail：lysong2@163.com

中图分类号: R681.53
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出版历程
- 收稿日期: 2025-10-26

Two cases of spondyloarthritis with dual HLA-B^*27 subtype positivity and literature review

HUANG Yue^{1, 2},
QIAN Luxin^{1, 2},
XU Congying¹,
YAO Lin^{1, 2},
LI Yasong^{1
, ,}

1.
Department of Rheumatology and Immunology, Zhejiang Provincial People's Hospital/Hangzhou Medical College Affiliated People's Hospital, Hangzhou 310014, China

摘要

摘要: HLA-B^*27亚型双阳性是一种罕见的脊柱关节炎基因表型，该表型可能与脊柱关节炎特定临床表型及疾病严重程度相关。本文报道HLA-B^*2704、HLA-B^*2705和HLA-B^*2704、HLA-B^*2702双阳性的2例脊柱关节炎病例，结合文献复习，总结HLA-B^*27亚型双阳性脊柱关节炎病例有以下特点：(1)HLA-B^*27亚型双阳性以HLA-B^*2704为基础亚型，最常见组合为HLA-B^*2704、HLA-B^*2705同时阳性，保护型亚型HLA-B^*2706未能体现保护效应；(2)患者以男性为主，临床表型多为中轴型脊柱关节炎；(3)患者对非甾体抗炎药反应欠佳，肿瘤坏死因子-α(TNF-α)抑制剂治疗应答良好。
- 脊柱关节炎 /
- 双阳性 /
- HLA-B^*27亚型 /
- 临床特点
Abstract: HLA-B^*27 dual positivity is a rare genetic phenotype in spondyloarthritis and may be associated with specific clinical manifestations and disease severity. This paper reports two cases of spondyloarthritis with dual positivity for HLA-B^*2704 and HLA-B^*2705, as well as for HLA-B^*2704 and HLA-B^*2702. Combined with a literature review, the following characteristics of spondyloarthritis with dual HLA-B^*27 subtype positivity are summarized: (1) Dual positivity of HLA-B^*27 subtypes is based on HLA-B^*2704, most commonly presenting as simultaneous positivity for HLA-B^*2704 and HLA-B^*2705; the protective subtype HLA-B^*2706 does not appear to exert a protective effects. (2) Most patients are male, with axial spondyloarthritis as the predominant clinical phenotype. (3) The patients show a poor response to nonsteroidal anti-inflammatory drugs demonstrate a favorable response to TNF-α inhibitors.
- Spondyloarthritis /
- Dual positivity /
- HLA-B^*27 subtype /
- Clinical features
利益冲突 无

HTML全文

图 1 HLA-B^*27亚型双阳性SpA病例1治疗前后MRI

注：A、B为治疗前可见左侧骶髂关节面下骨髓水肿；C、D为治疗后显示左侧骶髂关节未见异常。

Figure 1. MRI of HLA-B*27 dual-subtype-positive spondyloarthritis case 1 before and after treatment

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表 1 4例HLA-B^*27亚型双阳性SpA患者临床特点

Table 1. Clinical characteristics of 4 patients with HLA-B*27 dual-subtype-positive spondyloarthritis

序号	发病年龄	国籍	性别	亚型	累及部位	家族史	有效治疗
病例1	34	中国	男性	HLA-B^2702 HLA-B^2704	中轴(左骶髂)	无家族史	阿达木单抗
病例2	18	中国	男性	HLA-B^2704 HLA-B^2705	中轴(腰背、双侧骶髂)	无家族史	阿达木单抗
病例3^[18]	20	中国	男性	HLA-B^2704 HLA-B^2705	中轴(脊柱)、双髋	母亲有驼背病史(未诊治)	注射用重组人Ⅱ型肿瘤坏死因子受体-抗体融合蛋白
病例4^[19]	21	泰国	男性	HLA-B^2704 HLA-B^2706	中轴(腰背)、外周	父亲有AS病史	/
注：“/”表示原始文献未提供相关治疗信息。

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参考文献(22)

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