乙肝相关性肾炎的临床特征  

Clinical features of HBV-associated glomerulonephritis

作　　者：甘晓辉[1] 张林[1] 朱静[1] 

机构地区：[1]绵阳市中心医院肾内科,四川绵阳621000

出　　处：《四川医学》2013年第4期489-491,共3页Sichuan Medical Journal

摘　　要：目的总结乙型肝炎病毒相关肾炎(HBV-GN)的临床资料,探讨其临床表现,病理及免疫组化特点。方法经肾活检确诊为HBV-GN的60例患者,按年龄分成3组,分析3组的临床表现和病理特点。结果 60例HBV-GN中,少年组占65%,青年组和中老年组共占35%。临床表现以肾病综合征最常见,在少年组和青年组中,肾病综合征所占比例分别为30.8%和46.7%。少年组膜性肾病(MGN)和膜增殖性肾炎(MPGN)分别占48.7%和28.2%,青年组分别占33.3%和33.3%。乙肝染色HBeAg、HBsAg的检出率少年组分别为46.2%和33.3%,青年组分别为46.7%和66.7%,老年组为50%和66.7%。结论 HBV-GN以少儿多见,男性发病率高于女性,临床表现主要是肾病综合征,病理类型主要是MGN和MPGN,肾组织中乙肝病毒抗原沉积以HBeAg和HBsAg为主,HBVAg免疫组化标记是诊断HBV-GN的重要指标。Objective To explore the diagnosis and pathological features of hepatitis B virus associated glomerulonephritis （HBV-GN）. Methods 60 eases with HBV-GN diagnosed by renal pathology were divided into three groups by age, and the clinical and pathological features were analysised. Results The juvenile group was accounted for 65% ,youth group and older group total of 35%. The common clinical situation was nephritic syndrome, which were accounted for 30. 8% and 46. 7% in juvenile and youth group respectively. The constituent ratio of membranous nephropathy （MGN） and mesangioeapillary glomerulonephritis （MPGN） were respectively 48.7% and 28. 2% in juvenile group, 33. 3% and 33.3 % in youth group. The positive rates of HBeAg and HBsAg in renal samples were respectively 46. 2% and 33.3% in juvenile group, 46. 7% and 66. 7% in youth group, 50% and 66. 7% in older group. Conclusion HBV-GN is more common in children. Nephrotic sydrom is the primary clinical manifestation. MGN and MPGN are the mainly pathology types. HBVAg immunohistoehemieal markers are the important index for diagnosis of HBV-GN, as HBeAg and HBsAg are the really HBVAg deposition in the renal tissues.

关 键 词：乙型肝炎相关性肾炎 病理 临床 

分 类 号：R692.39[医药卫生—泌尿科学]