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目的:探讨乙型肝炎病毒相关性肾炎(HBV-GN)临床病理特点及乙型肝炎病毒(HBV)在HBV-GN发病中的作用。方法:对36例经肾穿刺证实的HBV-GN患者进行临床病理特点及病毒血清学分析。结果:36例HBV-GN患者平均年龄(36±13)岁,男女之比为1.25:1,血清HBsAg、HBeAg和抗-HBc(+)者10例,HBsAg、抗-HBe和抗-HBc(+)者5例,抗-HBs、抗-HBe、抗-HBc(+)者8例,一项或两项抗体阳性者13例。17例患者表现为肾病综合征(47.3%),12例表现为慢性肾炎(33.3%),7例无症状尿检异常(19.4%)。膜性肾病19例(52.8%),膜增生性肾炎4例(11.1%),系膜增生性肾炎13例(36.1%)。结论:HBV-GN男女比例相当,男性略多于女性,临床表现多为肾病综合征,病理类型以膜性肾病为主。
Objective: To investigate the clinicopathological features of hepatitis B virus-related nephritis (HBV-GN) and the role of hepatitis B virus (HBV) in the pathogenesis of HBV-GN. Methods: The clinical and pathological features of 36 patients with HBV-GN confirmed by renal biopsy and the viral serology were analyzed. Results: The average age of 36 patients (36 ± 13) was 36 ± 13, the ratio of male to female was 1.25: 1, serum HBsAg, HBeAg and anti-HBc were 10, HBsAg, anti-HBe and anti-HBc +) In 5 cases, anti-HBs, anti-HBe, anti-HBc (+) in 8 cases, one or two antibodies in 13 cases. Seventeen patients presented with nephrotic syndrome (47.3%), 12 with chronic nephritis (33.3%) and 7 with asymptomatic urinalysis (19.4%). Membranous nephropathy in 19 cases (52.8%), membranoproliferative glomerulonephritis in 4 cases (11.1%), mesangial proliferative glomerulonephritis in 13 cases (36.1%). Conclusions: The proportion of HBV-GN in men and women is quite high, while that in men is slightly more than that in women. Most of the clinical manifestations are nephrotic syndrome, and the pathological type is mainly membranous nephropathy.