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目的:探讨原发性IgA肾病(pIgAN)患者乙型肝炎病毒(HBV)感染情况、影响因素及HBV感染对其临床病理的影响。方法:采用固相放射免疫法检测了571倒pIgAN患者血清HBV抗原及抗体,以879名健康体检者为正常对照。分析影响IgAN HBV感染的因素。571例pIgAN分为A组(伴HBV感染者,n=88例)、B组(仅HBV抗体阳牲,n=88)、C组(无HBV感染者;n=395例)。比较三者的临床病理指标。结果。pIgAN HBV感染率为15.41%。显著高于健康体检者(3.19%)。不同年龄、性别、临床表现类型、肾功能状态的pIgAN之间HBV感染率无显著性差异。病程≥24个月者与病程<24个月者的HBV感染率分别为7.35%,17.93%,P<0.01。LeeⅣ～V级患者HBV感染率显著高于Ⅰ～Ⅲ级患者(P<0.05)。A组Ⅳ～V级所占比例高于B、C组,病理类型中系膜增生伴局灶节段性硬化占46.73%,显著较B、C组高(P<0.05)。三组在其他临床表现、新月体形成、球囊粘连、毛细血管内皮细胞增生、透明血栓形成、免疫复合物沉积部位及类型等方面无显著性差异。结论:pIgAN合并HBV感染高于健康人群,病程、病变程度为其影响因素,伴HBV感染pIgAN其肾组织病变较重。
Objective: To investigate the status of hepatitis B virus (HBV) infection in primary IgA nephropathy (pIgAN) and its influencing factors and the impact of HBV infection on its clinical pathology. Methods: Serum HBV antigens and antibodies in 571 patients with pIgAN were detected by solid-phase radioimmunoassay, and 879 healthy controls were used as normal controls. Analysis of factors affecting IgAN HBV infection. 571 cases of pIgAN were divided into group A (n = 88 with HBV infection), group B (n = 88 with HBV antibody only), group C (n = 395 without HBV infection). Comparison of the three clinical and pathological indicators. result. The pIgAN HBV infection rate was 15.41%. Significantly higher than the healthy physical examination (3.19%). There was no significant difference in HBV infection rates among different age, gender, clinical manifestations, and renal function status of pIgAN. The HBV infection rates of patients with duration of more than 24 months and duration of less than 24 months were 7.35% and 17.93%, respectively, P <0.01. The HBV infection rates in patients with Lee Ⅳ ~ V grade were significantly higher than those in patients with grade Ⅰ ~ Ⅲ (P <0.05). The proportion of grade IV-V in group A was higher than that in group B and C, and the percentage of mesangial hyperplasia with focal segmental sclerosis was 46.73% in pathological type, which was significantly higher than that in group B and C (P <0.05). There was no significant difference between the three groups in other clinical manifestations, crescent formation, balloon adhesion, capillary endothelial cell proliferation, clear thrombosis, immune complex deposition sites and types. Conclusion: The pIgAN with HBV infection is higher than that of healthy people. The course of the disease and the degree of the disease are the influencing factors. The pIgAN with HBV infection has severe renal pathology.