湖南地区乙型肝炎病毒相关性肾炎临床病理特征

Clinicopathological Features of Hepatitis B-associated Glomerulonephritis in Hunan

目的研究 38例乙型肝炎病毒相关性肾炎 (HBG )的临床及病理学特征。方法对 38例HBG患者肾穿刺组织进行光镜、电镜和免疫组化染色观察 ;按年龄分成少儿组和青壮年组 ,对其临床资料及病理学特征进行分析。结果少儿组 :均有浮肿病史 ,三大阳者 10 0 % ,合并肾病综合征者 79.2 % ,好发于男孩( 91.6 % ) ;青壮年组 :大部分有浮肿病史( 74.1% ) ,三大阳者 6 4.2 % ,合并肾病综合征者 42 .8% ,多见于男性 ( 71.4% )。结论HBG临床上以儿童多见 ,表现为肾病综合征 ,血清HBV标志物阳性。病理特征以膜性肾病为主 ,HBsAg。

ObjectiveTo study the clinicopathological features of 38 cases with hepatitis B-associated glomerulonephritis (HBG).MethodsHistopathological picture, ultrastructure and immunohistochemical reaction of the renal tissues obtained from kidney puncture were observed by light microscopy, electron microscopy and immunohistochemical staining in 38 cases with HBG. According to their ages, patients were divided into Group 1 (children group) and Group 2 (youth and adult group). Their clinical data and pathologic features were analyzed.ResultsIn Group 1, all cases had history of edema and revealed positive HBsAg, HBeAg and cAb (100%). Patients complicated with nephropathy syndrome accounted for 79.2%, and 91.6% of them were boys. As for Group 2, majority of the patients had history of edema (71.4%), 64.2% of them were positive carriers of HBsAg, HBcAg and cAb. Their complication of nephropathy syndrome amounted to 42.8%, males were predominately involved (71.4%).ConclusionsClinicopathological features of HBG are characterized by nephropathy syndrome and serologically positive marker of HBV, mostly seen in children. Pathologically, it belongs mainly to membranous nephropathy. Immunohistochemical markers of HBsAg and HBcAg are important criteria for diagnosis of HBG.