血清乙肝病毒抗原阳性肾小球肾炎患者的临床与病理对照分析

Clinicopathological analysis in serum HBV-positive glomerulonephritis

目的 :探讨血清乙肝病毒抗原阳性肾小球肾炎患者的临床与病理特征。方法 :采用血清乙肝病毒标志物阳性肾小球肾炎患者的临床与病理活检资料及实验室相关检查作对照分析。结果 :血清乙肝病毒标志物阳性患者中乙肝病毒相关性肾炎 (即伴有肾组织 HBV阳性 )的发病率为 4 7.5 % ;乙肝病毒相关性肾炎的主要临床表现为肾病综合征 (78.9% ) ;主要病理类型为膜性肾病 (5 2 .6% )和膜增生性肾小球肾炎 (2 1.1% ) ,免疫荧光 Ig G、C3和 Clq阳性率明显增高 (P<0 .0 5 ) ,肾小管间质病变明显较肾组织 HBV阴性组严重 (P<0 .0 1) ;血清免疫学检查发现 ,乙肝病毒相关性肾炎患者血清 e抗原阳性率较高 (84 .2 % ) ,而 e抗体阳性率较低 ,肾组织 HBV阴性组则相反。结论 :血清乙肝病毒抗原阳性患者肾组织 HBV阳性组与肾组织 HBV阴性组在临床表现、病理类型和实验室相关检查方面均有明显差异 ,在缺乏肾活检的情况下 。

Objective:To study the relationship between clinical and pathological features in serum HBV positive glomerulonephritis.Methods:The clinical data,laboratory results and pathological findings of renal biopsies in 40 patients with serum HBV positive glomerulonephritis were analyzed.Results:The incidence of HBV related glomerulonephritis was 47.5%(19/40).Among these patients,nephritic syndrome was the main manifestation;membranous nephropathy(52.6%)and membranous proliferative glomerulonephritis(21.1%) were the principal pathological types;the positive rates of IgG, C 3 and Clq staining and the degree of tubular interstitial lesions in renal tissues,and the positive frequency of serum e antigen were superior to those in renal HBV negative group( P< 0.05 0.001).Conclusion:In patients with serum HBV positive glomerulonephritis,there are obvious differences in the clinical manifestations,laboratory results and pathological types between renal HBV positive and HBV negative glomerulonephritis.Clinical manifestations and laboratory results appear to be helpful in diagnosing HBV related glomerulonephritis for lack of renal biopsy.