乙肝病毒相关性肾炎与人白细胞抗原相关性的探讨

The Investigation of the Relationship of Hepatitis B Virus - Associated Glomerulonephritis and Human Leucocyte Antigen

目的 :研究乙肝病毒相关肾炎与人白细胞抗原 (HLA)基因系统的相关性。方法 :采用NIH标准微量淋巴细胞毒试验方法 ,检测HLA A ,B抗原频率和基因频率 ;用改良的地依红染色法证明为乙肝病毒相关性肾炎 ,应用免疫组化ABC法检测肾组织的HLA Ⅰ ,Ⅱ类抗原阳性细胞数 ,并分别与原发性肾小球疾病患者及正常人肾组织作对照。结果 :乙肝病毒相关性肾炎患者血清中HLA A3、A10抗原频率高于正常对照组 ,统计学处理为A3 :Pc<0 .0 1,RR =16.3 3 ;A10 :Pc <0 .0 1,RR =10 .76。HBV GN患者肾组织上HLA Ⅱ抗原阳性细胞数显著高于原发性肾小球肾炎组 (P <0 .0 1)及正常对照组 (P <0 .0 1)。乙肝病毒感染无肝肾损害者血清中HLA B13抗原频率明显高于正常对照组 (Pc <0 .0 5 ,RR =9)。结论 :HLA A3 ,A10可能是乙肝病毒相关性肾炎的易感基因。HLA B13抗原强烈表达的乙肝病毒感染者不易发生肾组织的损害。肾组织上HLA Ⅱ类抗原强烈表达者易发生乙肝病毒相关性肾炎。

Objective: Our aim was to investigate the relationship between hepatitis B virus-associated glomerulonephritis(HBV GN) and human leucocyte antigen(HLA).Methods: We used NIH standard microlymphocy and toxicity assay to determine the frequencies of HLA and its gene. HLA A, B. Immunohistochemistry was used to detect the HLA-Ⅰ,Ⅱ cell number in renal tissues of patients with HBV GN . Results: The HLA-A3,A10 antigen frequencies in patients with HBV GN were significantly higher than these in controls (A3:Pc<0.01,RR=16.33; A10: Pc<0.01,RR= 10.76 ). The HLA B13 antigen frequency in patients with HBV infection and no renal damage were significantly higher than that in controls(B13:Pc<0.05,RR=9). In patients with HBV GN, the number of HLA Ⅱ positive cells were more obvious than that of patients with primal glomerulonephritis and controls.The difference was significant (P<0.01). Conclusion: The HLA A3,A10 may be genetic risk factors for susceptivity of HBV-GN. The HLA B13 may be resistant genetic risk factor for HBV GN. The HLA Ⅱ antigen may be significantly related to HBV-GN.