成人膜性乙肝病毒相关性肾炎与特发性膜性肾病临床病理特征比较

Comparison of clinical and pathological features between HBV-associated membranous nephropathy and idiopathic membranous nephropathy in adults

目的:探讨成人膜性乙肝病毒相关性肾炎(HBV-MN)与特发性膜性肾病(IMN)临床病理特征之间的异同。方法:回顾性分析HBV-MN(70例)与IMV(137例)患者的临床病理资料,分析比较2组的临床病理特征。结果:HBV-MN发病年龄小于IMN[(31.7±14.0)岁vs(47.1±13.0)岁;t=3.533,P<0.001];病理上HBV-MN伴发系膜增生较IMN更常见(98.6%vs69.3%;χ2=24.048,P<0.001),HBV-MN多为多种免疫复合物沉积,2组IgM、IgA、C3、C1q(χ2=18.175、21.990、16.448和50.846,P均<0.001)、FRA(P=0.007)在肾组织的沉积率差异均有统计学意义。结论:HBV-MN与IMN临床特征相似,病理改变存在一定差别,诊断需要临床与病理相结合综合分析。

Aim：To investigate the clinical and pathological differences between HBV-associated membranous nephropathy（HBV-MN）and idiopathic membranous nephropathy（IMN）in adults.Methods：Two hundred and seven patients with HBV-MN（n=70）or IMN（n=137）were enrolled in this study.The clinical and pathological results were compared between the two groups.Results：The mean age of the HBV-MN group was significantly younger than that of IMN group[（31.7±14.0）years vs（47.1±13.0）years;t=3.533,P0.001）].Mesangial proliferation was more commonly observed in HBV-MN group than that of IMN group（98.6% vs 69.3%;χ2=24.048,P0.001）,and immunofluorescence discovery of HBV-MN group was various immune-complex deposition,and the deposition of the immune-complex,IgM,IgA,C3,C1q（χ2=18.175,21.990,16.448,and 50.846,P0.001）,FRA（P=0.007）in the renal tissue between these two groups was statistically significant.Conclusion：Clinical features of HBV-MN are similar to those of IMN,but the two groups have their own characteristics in pathology,so the combination of clinical and pathological features is necessary to the diagnosis.