乙型肝炎病毒相关性肾炎的临床病理研究

• 作 者: 许冬梅 任万华 谭燕泉 赵洪涛 刘遵昌 周庚寅
• 机 构: 山东省立医院内科,山东省立医院内科,山东医科大学病理学教研室,山东省立医院内科,山东省立医院内科,山东医科大学病理学教研室
• 出 处: 山东医科大学学报
• 发表日期: 1999年03期
• 关键词: 肝炎病毒 临床 经皮活检 增殖性 膜性肾病 病毒复制指标 肾损害 血清标志物

对 ４４ 例 Ｈ Ｂ Ｖ 抗原血症并有尿检异常的患者进行了临床及肝、肾经皮活检病理研究，用 Ｐ Ｃ Ｒ 法检测肾组织中的 Ｈ Ｂ Ｖ Ｄ Ｎ Ａ，根据结果分组进行治疗观察。结果表明， Ｈ Ｂ Ｖ 相关性肾炎发病率为６５９％ （２９／４４）。２９ 例中膜性肾病 １３ 例，膜增殖性肾炎６ 例，系膜增殖性肾炎１０ 例。肾组织中 Ｈ Ｂ Ｖ Ｄ Ｎ Ａ 检出率为７２４％ 。慢性活动性肝炎并 Ｈ Ｂ Ｖ 相关性肾炎发病率高，用激素及干扰素配合治疗效果好。提示 Ｈ Ｂ Ｖ可通过多种机制引起肾损害， Ｈ Ｂ Ｖ 抗原血症并尿检异常并非全是 Ｈ Ｂ Ｖ 相关性肾炎。

Forty-four patients with Hb V antigenemia who had abnormal urinalysis were studied with pathology of liver and kidney by percutaneous biopsy, and Hb V-D N A in renal tissue was detected by P C R method. The results were grouped according to the results Treatment observation. The results showed that the incidence of H B V-related nephritis was 659% (29/44). 29 cases of membranous nephropathy in 13 cases, 6 cases of membranoproliferative glomerulonephritis, 10 cases of mesangial proliferative glomerulonephritis. The detection rate of H B VD N A in kidney was 724%. Chronic active hepatitis and high incidence of H B V-related nephritis, hormone and interferon with good treatment effect. It is suggested that H B V may cause renal damage through a variety of mechanisms, and H B V antigenemia and urinalysis abnormalities are not all H B V-related nephritis.