乙肝病毒相关性肾炎的临床与病理特点探讨(附62例分析)

Clinical and pathological analysis of HBV-associated glomerulonephritis-A report of 62 cases.

目的 探讨乙型肝炎病毒相关性肾炎 (HBV GN)的临床、病理特点。方法 分析我科经肾活检确诊的 6 2例HBV GV ,按年龄分成 3组 ,比较 3组的临床及病理特点。结果 少年组发病比率占 6 7.7% ,青年组及中老年组共占32 .3% ;少年组肾病综合征、镜下血尿分别占 31.0 %、11.9% ;青年组分别占 5 0 .0 %、2 1.4 %。少年组膜性肾病 (MGN)占4 5 .2 %、膜增殖性肾炎 (MPGN)占 2 8.6 % ;青年组MGN占 2 8.6 %、MPGN占 35 .7% ;中老年组MGN占 33.3%、MPGN占33.3%。乙肝染色HBeAg、HBsAg的检出率少年组分别为5 7.1%、4 0 .5 % ;青年组分别为 5 0 .0 %、6 4 .3%。结论 HBV GN以少儿多见 ,病理类型主要是MGN和MPGN 。

Objective To explore the clinical and pathological features of hepatitis B virus associated glomerulonephritis (HBV GN). Methods Sixty two cases of HBV GN diagnosed by renal pathology were divided into three groups by age. The clinical and pathological features of the three groups were compared.Results Incidence in juvenil group (group A) was 67.7% , 32.3% in youth group (group B) and middle old age group (group C) respectively. The incidence of nephritic syndrome (NS) and microscopic hematuria in group A was 31% and 11.9% , 50% and 21.4% in group B, respectively. The constituent ratio of membranous nephropathy (MGN) and mesangiocapillary glomerulonephritis (MPGN) were 45.2% and 28.6% in group A, 28.6% and 35.7% in group B, 33.3% and 33.3% in group C, respectively. The positive rate of HbeAg and HbsAg in renal sample was 57.1% and 40.5% in group A, 50% and 64.3% in group B, respectively.Conclusion Involvement of HBV GN is more common in juvenil. Main histological type of HBV GN is MPGN. The major deposition of HBV antigen in renal tissue is HbsAg and HbeAg.