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机构地区:[1]青岛大学医学院附属医院,山东青岛266003
出 处:《中国实验诊断学》2001年第4期161-163,共3页Chinese Journal of Laboratory Diagnosis
摘 要:目的 比较乙型肝炎病毒相关性肾炎 (HBV -GN )与非乙型肝炎病毒相关性肾炎 (NHBV -GN)的肾脏病理学变化。方法 将我院 2 4例肾脏活检组织进行免疫组织化学 ,HE ,PAS ,PASM和Masson染色后镜检 ,并对血清乙型肝炎病毒(HBV)感染指标、HBV -DNA、肾活检组织进行HBV -DNA多聚酶链反应 (PCR)、Southern印迹及分子杂交检测。结果 符合HBV -GN诊断标准者 10例 ,占总数的 41.6 % ,其中膜性肾病 (MN)、IgA肾病系膜增生性肾炎 (MsPGN)和系膜毛细血管性肾炎 (McGN)分别为 4例、4例和 2例 ,占HBV -GN的 40 %、40 %和 2 0 % ;NHBV -GN 14例 ,占 5 8.4% ,其中MN3例、MsPGN3例、McGN2例、系膜增生 5例和轻微病变 1例 ,各占NHBV -GN的 2 1.4% ,2 1.4% ,14 .2 % ,35 .7%和 7.1%。IgA肾病在两组中占 7/2 4( 2 9% )。HBV -GN之MN与NHBV -GN比较有四点不同 :1,肾小球基底膜增厚但钉突不明显 ;2 ,增厚的基底膜呈链环状 ;3 ,伴有轻度系膜增生 ;4,不但有C3、IgG沉积 ,还有IgA沉积。其他两种病理类型的免疫组织化学显示IgA、IgG沉积HBV -GN组多于NHBV -GN组 ,组间有明显差异 (P均 <0 .0 5 )。 结论 HBV -GN与NHBV-GN之病理类型大致相似 ,HBV -GN在我地区以MsPGN为主 ,而不是MN。Objectives To compare pathologic changes of kidneys in hepatitis B virus associated nephritis and non- hepatitis B virus associated nephritis. Methods 24 patients with glomerulonephritic syndrome were experienced biopsy. We examined renal tissues processed and stained by immunobiochemistry, HE, PAS, PASM and Masson, meanwhile serum HBsAg, Anti-HBs, HBeAg, Anti-HBe, Anti-HBc, HBV-DNA , and HBV-DNA in the renal tissues were assayed by PCR, Southern and molecular cross assay. According to the above results, patients with HBV-DNA positive would be assigned into HBV-GN group and the rest would be assigned into control group. Results 10 of 24 cases (41.6%) were diagnosed as HBV-GN, of which 4 cases (40%) as membranous nephropathy; 4 cases (40%) as IgAN MsPGN and 2 cases (20%) as McGN; 14 cases(58.4%) were diagnosed as NHBV-GN, of which 3 cases (21.4%) as IgAN MsPGN, 3 cases (21.4%) as membranous nephropathy; 2 cases (14.2%) as McGN, 5cases(35.7%) as non-IgA MsPGN and 1 case as minor glomerular abnormalities. Compared to MN, there were four features in HBV-GN: 1, incrassation of glomerular basal spiky projection was not obvious; 2, The thickened basal membrane was chain-shaped; 3, Mesangioproliferation was companied mildly; 4, C3 and IgG as well as IgA was deposited. Immunohistochemistry showed there was significant difference between NHBV-GN group and HBV-GN group(P<0.05). Results There are the samilar pathologic types of HBV-GN to that of NHBV-GN; MsPGN is donimant in our area, unlike some reports that MN of HBV-GN was.
关 键 词:乙型肝炎病毒相关性肾炎 非乙型肝炎病毒相关性肾炎 肾组织活检
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