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目的探讨血清乙型肝炎病毒标志物阴性的乙肝病毒相关性肾炎患者的临床特点。方法在所有肾活检确诊乙型肝炎病毒相关性肾炎的患者中,筛选出7例血清乙型肝炎病毒标志物阴性的患者。对他们活检前临床诊断、实验室检查及活检结果等进行分析。结果7例患者肾活检前临床诊断种类较多,但均未考虑乙型肝炎病毒相关性肾炎的诊断,最终均经肾活检而确诊。其病理改变均为不典型膜性肾病。结论临床中有少数患者尽管血清乙型肝炎病毒标志物阴性,但仍不能完全除外乙型肝炎病毒相关性肾炎,尤其是肾活检出现不典型膜性肾病时,一定要重视肾活检标本乙型肝炎病毒免疫荧光的检查。以免误诊漏诊。
Objective To investigate the clinical features of hepatitis B virus-negative patients with hepatitis B virus-associated nephritis. Methods Seven patients with negative serum hepatitis B virus markers were screened out from all patients with hepatitis B virus-associated nephritis diagnosed by renal biopsy. Their biopsy before the clinical diagnosis, laboratory tests and biopsy results were analyzed. Results There were more clinical diagnoses before renal biopsy in 7 patients, but no diagnosis of hepatitis B virus-associated nephritis was considered. All patients were confirmed by renal biopsy. The pathological changes are atypical membranous nephropathy. Conclusions Although a small number of patients in clinic may not completely exclude hepatitis B virus-associated nephritis despite the negative serum HBV markers, especially when renal biopsy has atypical membranous nephropathy, we must pay attention to hepatitis B Virus immunofluorescence examination. To avoid misdiagnosis.