目的检测强直性脊柱炎(AS)及其他风湿性疾病患者血清中抗链球菌溶血素0(ASO)的浓度,探讨ASO在AS诊断及疾病进展评估中的意义。方法采用胶乳凝集法检测AS患者及疾病对照者血清中的ASO水平。记录AS患者临床特征及影像学分级,并分析与ASO的关系。结果①121例AS患者中有40例ASO阳性(〉200IU/m1),阳性率为33.1%,在124例对照者中仅有6.5%阳性,AS患者中ASO阳性率显著高于对照组(P〈0.01),AS患者血清ASO水平明显高于对照组[分别为(211.05±303.04)和(69.40±56.72)IU/ml,P〈0.01]。②在AS患者中,ASO阳性组IgG水平显著高于ASO阴性组(P〈0.01)、血红蛋白水平明显低于ASO阴性组(P〈0.05);影像学检查中骶髂关节炎Ⅱ级以上改变比例明显高于ASO阴性组(P〈0.05);4字试验阳性的发生率显著高于ASO阴性组(P〈0.05);ASO阳性组患者平均年龄显著低于ASO阴性组患者(P〈0.05)。⑧相关性分析显示,血清ASO水平与红细胞沉降率(ESR)、IgG呈正相关(t s=0.229,P〈0.05;x=0.262,P〈0.01)。结论AS患者溶血性链球菌感染发生率高于其它风湿性疾病,溶血性链球菌感染可能参与As的发病,血清ASO检测有助于AS的诊断及疾病进展情况的评估。
Objective To detect the concentration of anti-streptolysin O (ASO) in ankylosing spongylitis ( AS), and analyze its clinical significance in the diagnosis and disease progress. Methods Latex agglutination was used to detect ASO in sera of 121 AS patients and 124 patients with other connective tissue diseases. Results ( Of the 121 AS patients, 33.1% were seropositive for ASO. Only 6.5% of 124 control patients were seropositive (P 〈 0.01). The level of ASO in AS was higher than that of the control group [(211.05 +303.04) vs (69.40 + 56.72) IU/ml, P 〈0. 011 ; In AS group, patients with positive ASO were characterized by higher level of IgG and decreased level of Hb (P 〈 0. 01, P 〈 0.05) , and experienced higher incidences of cacroiliac joint X ray a- bove phase lI , positive sign of Figure 4 (P 〈 0.05). Patients with positive ASO were younger than those with negative results (P 〈 0.05) ; ( ASO was positively associated with IgG (rs = 0. 229, P 〈 0.05) and ESR ( r = 0. 262, P 〈 O. 01 ). Conclusion Hemolytic streptococcus infection displays more frequency in patients with AS than other rheumatic diseases, suggesting that streptococcal infection, may contribute to the diagnosis of AS and the progression of disease.