慢性乙型肝炎病毒感染者免疫耐受期的早期肾损伤监测

Monitoring on early renal damage during immune tolerant phase in patients with chronic hepatitis B virus infection

目的检测尿微量清蛋白(mALB)、尿β2-MG、尿N-乙酰-β-氨基葡萄糖苷酶(NAG酶),评价慢性"乙型肝炎病毒感染者免疫耐受期"的早期肾损伤。方法测定乙型肝炎病毒(HBV)感染"免疫耐受"者实验组(122例)尿微量清蛋白、尿β2-MG和尿NAG酶,同时与健康者(60例)和慢性乙型肝炎患者(60例)进行对照分析,同时结合血液肾功能、HBV DNA含量、感染期,评价HBV感染免疫耐受期的早期肾损伤。结果实验组尿液3项水平显著高于健康对照组而低于慢性乙型肝炎患者组;实验组大于35岁者尿液3项指标均值显著高于小于35岁组;HBV感染免疫耐受者HBV DNA对数值在4.00～6.00之间的β2-MG和mALB均值水平显著低于对数值在6.00以上的。结论血液中HBV DNA的含量越高,对肾脏的致病作用就越强。

Objective To evaluate the early renal damage during immune tolerant phase in patients with chronic hepatitis B virus（HBV） infection.Methods Urinary β2-microglobulin（β2-MG）,urinary microalbumin（mALB）and urinary N-acetyl-β-glucosaminidase（NAGase） were detected for 122 cases of patients at immune tolerant phase with chronic HBV infection（experimental group）,60 healthy individuals（healthy control group） and 60 cases of patients with chronic hepatitis B （CHB group）,and were used to evaluate the early renal damage in patients with chronic HBV infection,combined with serum indexes of renal function,levels of HBV DNA and infection period.Results Levels of the 3 detected urinary items of experimental group were significantly higher than those of healthy control group and lower than those of CBH group. In experimental group,levels of the 3 urinary items of the individuals less than 35 years old were significantly lower than those more than 35 years old,and levels of β2-MG and mALB of the individuals with HBV DNA log-value between 4.00-6.00 were significantly lower than those with HBV DNA log-value over 6.00.Conclusion It could be suggested that the higher of the level of HBV DNA,the stronger pathopoiesis on kidney.