乙肝病毒相关性肾炎62例的诊断与治疗分析  

Diagnosis and Therapy Analysis for HBV-Associated Glomerulonephritis in the 62 Cases

作　　者：李玉斌[1] 叶朝阳[2] 栗金艳 孙田美[2] 梅长林[2] 

机构地区：[1]湖北省宜昌市第一人民医院肾内科,宜昌443000 [2]第二军医大学附属长征医院肾内科解放军肾脏病中心,上海200003 [3]湖北省当阳市第二人民医院肾内科,当阳444100

出　　处：《中国中西医结合肾病杂志》2002年第8期463-465,共3页Chinese Journal of Integrated Traditional and Western Nephrology

摘　　要：目的 :总结乙肝病毒相关性肾炎 (HBV -GN)的临床资料 ,探讨其诊断及治疗。方法 :将经肾活检确诊的 6 2例HBV -GN ,按年龄分为 3组 ,分析 3组的临床、病理特点 ,观察激素及α -干扰素 (α -IFN)对HBV -GN中表现为肾病综合征 (NS)的膜性肾病 (MGN)的治疗反应。结果 :少儿组发病率最高 ,占 6 7.7% ;临床表现以NS、镜下血尿多见。少儿组MGN占 4 5 .2 %、膜增殖性肾炎 (MPGN)占 2 8.6 % ;青壮年组MGN占 2 8.6 %、MPGN占 35 .7% ;中老年组MGN占 33.3%、MPGN占 33.3%。肾组织乙肝染色少儿组HBeAg、HBsAg检出率分别为 5 7.1%、4 0 .5 % ;青壮年组HBeAg、HBsAg检出率分别为 5 0 %、6 4 .3%。激素组中 2例完全缓解 ,3例部分缓解 ,2例无效 ;α -IFN组中 2例完全缓解 ,3例部分缓解 ,1例无效。结论 :HBV -GN的临床表现与原发性肾小球疾病类似 ,肾组织切片上找到HBV抗原在诊断中最重要。激素及α -IFN在HBV -GN治疗中有一定作用。Objective:To explore the diagnosis and therapy of hepatitis B virus associated glomerulonephritis (HBV-GN).Methods:Sixty-two cases with HBV-GN diagnosed by renal pathology were divided into three groups by age. The clinical and pathological features of the three groups were compared. The curative effects of hepatitis B virus-associated membranous nephropathy with steroid hormone or alpha-interferon (α-IFN) were observed.Results:Incidence rate of HBV-GN in juvenil group (group A) was 67.7%,which was the most. The common clinical situation were nephritic syndrome (NS) and microscopic hematuria. The constituent ratio of membranous nephropathy (MGN) and mesangiocapillary glomerulonephritis (MPGN) were respectively 45.2% and 28.6% in group A, 28.6% and 35.7% in group B, 33.3% and 33.3% in middle-old-age group (group C).The positive rate of HBeAg and HBsAg in renal sample were respectively 57.1%and 40.5% in group A, 50% and 64.3% in group B.In group of treatment with steroid hormone two cases were fully remission, three cases were part remission and two cases were inefficiency.In group of treatment with α-IFN, two cases were fully remission, three cases were part remission and one case was inefficiency. Conclusions:Clinical situation of HBV-GN is similar with primary glomerulonephritis. It is the most important that HBV antigen is found in renal tissue. It is may be useful that the treatment with steroid hormone or α-IFN for patients with HBV-GN.

关 键 词：乙肝相关性肾炎 诊断 治疗 临床分析 

分 类 号：R692.3[医药卫生—泌尿科学]