血清乙型肝炎病毒DNA定量对乙型肝炎病毒相关性肾炎的影响

Department of nephrology, The medical school hospital of Qingdao university

目的回顾性研究血清乙型肝炎病毒DNA（HBV-DNA）定量与乙型肝炎病毒相关性肾炎（HBV-GN）临床表现、肾脏病理演变及预后的相关性。方法根据HBV-DNA复制程度,将41例HBV-GN患者分为3组,分别测定患者的24小时尿蛋白定量、血浆白蛋白、胆固醇、甘油三酯及肌酐;检验其中35例膜性肾病病理分期与病毒DNA复制高低相关性以及病毒复制水平与治疗总有效率的相关性。结果①随着血清HBV-DNA定量的增加,患者的尿蛋白定量升高,血浆白蛋白降低,胆固醇及甘油三酯升高,差别具有统计学意义（p〈0.05）;血肌酐水平随着血清HBV-DNA定量的增加也升高,但差别无统计学意义。②随着血清HBV-DNA定量增加,35例膜性肾病患者的肾脏病理病变逐渐加重,DNA定量水平与病理变化之间存在相关性（p〈0.05）。③随着血清HBV-DNA定量增加,HBV-GN患者治疗的总有效率降低,差别具有统计学意义（p〈0.05）。结论随着血清HBV-DNA定量增加,HBV-GN患者的临床表现及肾脏病理表现加重,治疗的总有效率降低,其变化存在相关性。

Objectives To investigate the correlation with the content of hepatitis B virus DNA （HBV - DNA） in surum and hepatitis B virus associatedglomerulonephritis （HBV -GN） in manifestation, pathology and prognosis. Methods 41 HBV - GN patients were divided into 3 groups by the content of HBV - DNA in surum, and determine 24h urinary protein excretion, plasma albumin, serum triglyceride and cholesterol, serum creatinine;To analyse the relationship with the content of HBV - DNA in surum and pathologic stage in 35 membranous glomerulop- athy patients ; The relationship with the content of HBV - DNA in surum and prognosis. Results @With the rising of the content of HBV - DNA in surum, The urinary protein, plasma albumin, serum triglyceride and cholesterol were increasing,There was significant differrence in statistic（ P 〈0.05 ）. With the rising of the content of HBV - DNA in surum, serum creatinine was also increasing,But there was no significant differrence in statistic（ p 〉0.05 ）. （2）With the rising of the content of HBV - DNA in surum,The pathologic change was aggravating from stage Ⅰ to stage Ⅲ in membranous glomerulopathy patients（ p 〈 0.05 ）. （3）With the rising of the content of HBV - DNA in surum, The prognosis was decreasing（ p 〈0.05 ）. Conclusions With the rising of the content of HBV - DNA in surum, The manifestation and pathology were aggravating, The prognosis was decreasing. There was significant differrence.