丙型肝炎病毒感染后肾小球肾炎

HEPATITIS C VIRUS-INDUCED GLOMERULONEPHRITIS

为探讨丙型肝炎病毒(HCV)感染与肾小球肾炎的关系,本文应用免疫组化技术以抗-HCVNS_3和抗-HCV NS_5单克隆抗体对21例丙肝石蜡包埋尸解肾组织中的丙肝抗原(HCAg)进行了检测。结果:检测出阳性13例(61.9%),其中膜增殖性肾炎(MPGN)11例和系膜增殖性肾炎(MsPGN)1例.另有1例未见明显病变。HCAg 阳性颗粒定位于肾小球系膜区、系膜细胞及肾小管上皮细胞胞浆内。HCAg阴性病例中包括 MsPGN2例、膜性肾病(MN)及毛细血管内增生性肾炎(PSGN)各1例,4例大致正常。同本文抽选的乙型肝炎病毒(HBV)感染对照组肾脏病理变化相比,丙肝患者出现肾小球肾炎更为多见,尤其是 MPGN 型(X^2=101,P<0.01),且呈多样化。本文肾组织中 HCAg 的检出为 HCV 相关性肾炎的存在提供了新的形态学依据。

To explore the relationship between hepatitis C virus(HCV)infection and glomeru- lonephritis,21 cases of paraffin-embedded renal autopsy tissue taken from patients with HCV infec- tion were examined by immunohistochemical techniques(S-P assay)with monoclonal anti-HCV NS3 and anti-HCV NSS.HCAg positive particles were detected in 13 cases(61.9%).in which 11 cases were identified as membranoproliferative glomerulonephritis(MPGN),1 case as mesangial prolifera- tive glomerulonephritis(MsPGN),and another 1 case without obvious lesion.In the 8 HcAg negative cases,2 cases were identified as MsPGN,1 case as membranous glomerulonephritis(MN),and 1 case as postinfectious glomerulonephritis(PSGN),4 cases with no obvious lesion.Renal lesions were more diverse and common in hepatitis c than in hepatitis B patients which were chosen as control.The detection of HCAg in this study provided a new morphological evidence for the existance of HCV re- lated glomerulonephritis.