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探讨乙型肝炎病毒 (HBV )感染与成人原发性肾小球肾炎 (肾炎 )发病的联系。方法 :用间接免疫荧光法检测 16 9例成人原发性肾炎患者肾活检冰冻切片组织 HBs Ag和 HBc Ag的沉积情况。按血清HBV感染标志物检测分血清阳性和阴性两组进行分析。结果 :肾组织 HBs Ag和 HBc Ag的阳性率分别为14.2 %和 10 .9%。HBV抗原 (HBAg)总阳性率为 15 .4% (2 6 /16 9)。其中系膜毛细血管性肾炎、膜性肾病和系膜增生性肾炎的阳性率分别达 10 0 .0 %、5 8.8%和 37.5 %。原发性肾炎血清 HBV感染标志物阳性率为 35 .5 %。血清阳性组肾组织 HBAg的阳性率为 38.3% ,与血清阴性组 (3.7% )相比 ,差别有统计学意义 (χ2 =34.6 ,P<0 .0 0 1)。按病理类型分析发现 ,膜性肾病血清阳性组的肾组织 HBAg阳性率为 83.3% (10 /12 ) ,与其血清阴性组 (2 0 .0 % ,1/5 )相比 ,差别有统计学意义 (P<0 .0 5 )。结论 :成人原发性肾炎及原发性膜性肾病肾活检组织 HBAg沉积与血清 HBV感染标志物阳性之间存在正相关 ,提示成人原发性肾炎特别是膜性肾病的发病与 HBV感染有关。
To investigate the relationship between hepatitis B virus (HBV) infection and adult primary glomerulonephritis (nephritis). Methods: Indirect immunofluorescence assay was used to detect the deposition of HBsAg and HBcAg in renal biopsy frozen sections from 169 adult patients with idiopathic nephritis. Serum HBV infection markers detected by seropositivity positive and negative two groups were analyzed. Results: The positive rates of HBsAg and HBcAg in kidney were 14.2% and 10.9% respectively. The total positive rate of HBV antigen (HBAg) was 15.4% (26/169). The positive rates of mesangial capillary nephritis, membranous nephropathy and mesangial proliferative glomerulonephritis were 100.0%, 58.8% and 37.5% respectively. The positive rate of serum HBV infection markers in primary nephritis was 35.5%. The positive rate of HBAg in seropositive group was 38.3%, which was significantly different from that in seronegative group (3.7%) (χ2 = 34.6, P <0.001). According to the histopathological analysis, the positive rate of HBAg in renal tissue of membranous nephropathy seronegative group was 83.3% (10/12), which was significantly different from that of seronegative group (20.0%, 1/5) (P <0. 05). Conclusion: There is a positive correlation between HBAg deposition and serum HBV infection markers in adults with primary nephritis and primary membranous nephropathy, suggesting that the incidence of adult primary nephritis, especially membranous nephropathy, is related to HBV infection.