儿童与成年人乙型肝炎病毒相关性膜性肾病的临床病理对比分析  

Comparative study of clinic and pathologic data of hepatitis B virus ralated membranous nephropathy between children and adult

作　　者：钟晓容[1] 庄永泽[2] 林婷[1] 

机构地区：[1]福建医科大学福总临床医学院,福州350025 [2]南京军区福州总医院肾脏科,350025

出　　处：《中国医师进修杂志》2010年第34期27-29,共3页Chinese Journal of Postgraduates of Medicine

基　　金：基金项目：福建省科技厅重点基金（2007Y0030）

摘　　要：目的 比较儿童与成年人乙型肝炎病毒相关性膜性肾病（HBV-MN）的临床病理特点,探讨二者之间的异同点.方法 将90例HBV-MN患者按年龄分为儿童组（33例）与成年人组（57例）,对其临床病理资料进行回顾性病例对照研究.结果 儿童组贫血发生率为45.45%（15/33）,明显高于成年人组的15.79%（9/57）（P＜0.01）.两组临床分型均以肾病综合征为主,但各种临床分型构成比较差异无统计学意义（P＞0.05）.两组病理分期均以Ⅱ期膜性肾病为主,儿童组Ⅱ期膜性肾病发生率为63.64%（21/33）,明显高于成年人组的42.11%（24/57）（P＜0.05）;儿童组免疫组化＂满堂亮＂发生率及肾组织切片HBcAg沉积率亦高于成年人组（P＜0.05）.结论 儿童与成年人的HBV-MN既有相同点,也有不同点.熟悉二者异同点,将有助于HBV-MN诊治水平的提高.Objective To discuss the similarities and differences of clinical manifestation and pathological characteristics in hepatitis B virus related membranous nephropathy （HBV-MN） between children and adult. Methods Ninety cases with HBV-MN were divided into two groups according to the age：children group （33 cases） and adult group （57 cases）. A retrospective control study was carried out to analyze the clinical and pathological features of the two groups. Results The incidence of anemia in children group was 45.45% （ 15/33 ）, which was significantly higher than that in adult group [15.79% （9/57）]（P 〈 0.01）. Nephrotic syndrome was the largest proportion in two groups,but there was no significant difference in the composition of clinical manifestations between two groups （P 〉0.05）. Membranous nephropathy Ⅱ was common in pathological stage in two groups. The incidence of membranous nephropathy Ⅱ in children group was 63.64% （21/33）,which was significantly higher than that in adult group [42.11%（24/57）] （P 〈 0.05 ）;immunohistochemistry showed ＂all bright＂, and the deposition of HBcAg in renal biopsy was also higher than that in adult group （P 〈 0.05）. Conclusion There are some similarities and differences in HBV-MN between children and adult patients,and these will help to improve the levels of diagnosis and treatment.

关 键 词：肝炎病毒 乙型 肾病综合征 膜性肾病 

分 类 号：R51[医药卫生—内科学] R692[医药卫生—临床医学]