目的：探讨抗核抗体(ANA)、抗中性粒细胞胞质抗体(ANCA)、人类白细胞抗原B27(HLA-B27)、抗双链DNA抗体(anti-dsDNA)在诊断免疫相关性葡萄膜炎中的价值。

方法：选取70例免疫相关性葡萄膜炎患者，收集患者的临床资料，检测患者血清中ANA、ANCA、anti-dsDNA和外周血淋巴细胞HLA-B27的表达水平。

结果：男性患者年龄低于女性(t=2.845，P<0.05)； 70例免疫相关性葡萄膜炎患者中，脊柱关节炎、原发性系统性血管炎、系统性红斑狼疮、原发性干燥综合征、类风湿性关节炎及幼年性特发性关节炎分别有42、12、6、5、4、1例，男女之间其中脊柱关节炎和系统性红斑狼疮比例差异有统计学意义(P=0.019、0.008)。ANA阳性率为16%(11/70)，ANCA阳性率为10%(7/70)，HLA-B27阳性率为59%(41/70)，anti-dsDNA阳性率为6%(4/70)； 其中，男性的ANA、ANCA、anti-dsDNA阳性率均低于女性(P<0.05)，男性HLA-B27阳性率高于女性(χ²=4.427，P<0.05)，差异均具有统计学意义。70例免疫相关性葡萄膜炎发病部位主要是前葡萄膜(49%)和全葡萄膜(46%)。ANA主要在系统性红斑狼疮(83%)和原发性干燥综合征(60%)中表达； ANCA在免疫相关性葡萄膜炎中均有表达(除外脊柱关节炎和幼年性特发性关节炎)； HLA-B27主要在脊柱关节炎(93%)中表达； anti-dsDNA主要在系统性红斑狼疮(67%)和类风湿性关节炎(25%)中表达。

结论：ANA、ANCA、HLA-B27、anti-ds DNA的阳性率在不同免疫相关性葡萄膜炎的表现类型具有差异，对于免疫相关性葡萄膜炎的分类具有一定的辅助诊断作用。

METHODS: Totally 70 patients with immune-related uveitis were selected and the clinical data were collected. The levels of ANA, ANCA, anti-dsDNA in serum and HLA-B27 in peripheral blood lymphocytes were measured.

RESULTS: Male patients were younger than femle patients(t=2.845, P<0.05); there were 42 cases, 12 cases, 6 cases, 5 cases, 4 cases, 1 case, repectively in spondyloarthritis, primary systemic vasculitis, systemic lupus erythematosus, primary Sjogren's syndrome, rheumatoid arthritis and juvenile idiopathic arthritis among the 70 patients with immune-related uveitis. The proportion of spondylitis and systemic lupus erythematosus between men and women had significant difference(P=0.019, 0.008). The ANA positive rate was 16%(11/70), the positive rate of ANCA was 10%(7/70), the positive rate of HLA-B27 was 59%(41/70), the positive rate of anti-dsDNA was 6%(4/70). Among the cases, in male ANA, ANCA, anti-dsDNA positive rate was lower than in women(P<0.05). The positive rate of HLA-B27 in male was higher than that in female, the difference was significant(χ²=4.427, P<0.05). The main site of the disease in 70 cases of immune-related uveitis were the anterior uvea(49%)and the entire uvea(46%). ANA was mainly expressed in systemic lupus erythematosus(83%)and primary Sjogren's syndrome(60%); ANCA was expressed in immune-related uveitis(except for spondyloarthritis and juvenile idiopathic arthritis); HLA-B27 was predominantly expressed in spondylarthritis(93%); anti-dsDNA was mainly expressed in systemic lupus erythematosus(67%)and rheumatoid arthritis(25%).

CONCLUSION: The positive rates of ANA, ANCA, HLA-B27 and anti-dsDNA are different in different immunological-related uveitis, which has a certain diagnostic effect on the classification of immune-related uveitis.