尿HBsAg特异性免疫复合物检测在乙肝病毒相关肾炎中的临床意义  

The clinical significance of detecting urinary HBsAg immune complex in children with HBV associated glomerulonephritis

作　　者：李永柏[1] 刘昌林[1] 张恒言[1] 李秋[1] 张远维[1] 梁大才[1] 王晓东[2] 唐宜[3] 

机构地区：[1]重庆医科大学附属儿童医院,400014 [2]第三军医大学病理室 [3]重庆医科大学电镜室

出　　处：《中华儿科杂志》1999年第8期477-480,共4页Chinese Journal of Pediatrics

基　　金：国家自然科学基金

摘　　要：目的　探讨尿ＨＢｓＡｇ免疫复合物（ＩＣ） 的检测在乙肝病毒相关肾炎中的诊断意义。方法用ＰＥＧ沉淀结合胰蛋白酶解离法测定三组（Ａ组ｎ ＝２１，Ｂ组ｎ＝９ ，Ｃ组ｎ＝ １８）尿ＨＢｓＡｇＩＣ，并与肾组织免疫荧光检测结果进行对比。结果　经肾活检确诊有ＨＢｓＡｇ 肾沉积的１０ 例乙肝病毒相关肾炎中，尿ＨＢｓＡｇＩＣ阳性检出率达９０％ ；非乙肝病毒相关肾炎（ 血ＨＢｓＡｇ 阳性，无ＨＢｓＡｇ 肾组织沉积）１０ 例中尿ＨＢｓＡｇＩＣ阳性率仅１０％ ；而血ＨＢｓＡｇ 阳性但无临床疾病的健康儿童中尿ＨＢｓＡｇＩＣ 阳性率为６ ％ ，且尿ＨＢｓＡｇＩＣ检测结果与肾组织ＩｇＧ、Ｃ３ 、电子致密物沉积也密切相关。结论　尿ＨＢｓＡｇＩＣ 检测对难以施行肾活检的患儿诊断乙肝病毒相关肾炎，了解肾组织免疫复合物损伤是一种较为可靠的辅助检测手段。Objective To determine the correlation between the detection of urinary HBsAg immune complex (HBsAg IC) and deposition of HBsAg as well as immune reactants on glomeruli and to establish the diagnostic value of detecting HBsAg IC in children with HBV associated glomerulonephritis (HBV GN). Methods The study used the method of PEG precipitation combined splitting with trypsine and the technique of immunofluorescence to compare the results of detecting urinary HBsAg IC with the deposits of HBsAg, IgG, C 3 and electron density on glomeruli. Results The study showed a higher positive rate (90%) of urinary HBsAg IC in 10 children with HBV GN and a lower positive rate (10%) in 10 children with glomerular diseases without HBV deposition on glomeruli but HBV positive in serum. However, the positive rate of urinary HBsAg IC was 6% in healthy carriers of HBV. There was a positive correlation between urinary HBsAg IC and glomerular deposits of IgG, C 3, electron density. Conclusion The detection of urinary HBsAg IC may become a useful supplementary method for diagnosing HBV GN in children who could not receive renal biopsy.

关 键 词：HBSAG 抗原抗体复合物 乙型肝炎病毒 肾炎 

分 类 号：R692.3[医药卫生—泌尿科学]