血清HBsAg阳性IgA肾病肾组织HBV抗原蛋白及血清和肾组织HBV-DNA检测分析

目的探讨乙型肝炎病毒（HBV）感染与IgA肾病发病的关系。方法32例肾活检冰冻切片组织HBsAg和HBcAg蛋白和42例HBsAg阳性的肾活检石蜡切片组织及其部分血清HBV-DNA的检测。结果HBsAg和HBcAg在IgA肾病肾活检组织的总阳性率为59．1％，在非IgA肾病中的总阳性率为63．6％，二者差异无统计学意义。42例肾活检组织中，仅发现有5例（11．9％）在肾活检组织中有HBV-DNA的存在。且5例均为大三阳患者，其病理诊断为系膜增生性肾小球肾炎2例，轻微肾小球病变1例，基底膜病变1例，IgA肾病仅1例。血清HBsAg阳性的患者，同时进行了42例肾活检组织的血清HBV-DNA检测，其中大三阳患者为12例，其血清HBV-DNA均为阳性，而这12例血清阳性的肾活检组织中仅有5例HBV-DNA为阳性，其余30例血清及肾活检组织中HBV-DNA为阴性。结论HBsAg和HBcAg蛋白在IgA肾病肾活检组织和非IgA肾病肾活检组织表达差异无统计学意义，表明HBV感染与IgA肾病并无直接关系。

Detection and analysis of HBV antigen protein in kidney tissue and HBV-DNA in serum and kidney tissue of patients with HBsAg + IgA nephropathy

Objectives To explore the relationship between hepatitis B virus (HBV)infection and development of IgA nephropathy.Methods HBsAg and HBcAg protein in renal biopsy specimens of 32 cases was detected on frozen sections and HBV-DNA was detected in paraffin section of renal biopsies and in serum of 42 HBsAg positive cases. Results The positive rate of HBAg in renal biopsies of IgA nephropathy was 59.1%, and 63.6% in non-IgA nephropathy, there was no significant difference between them. In 42 cases biopsies of renal tissues, only five were HBV-DNA positive(11.9%).The five cases were HBsAg, HBcAb and HBeAg positive, the pathological diagnosis of two cases were mesangial proliferative glomerulonephritis; one had minimal change of glomerulonephritis; and one had basement membrane change; and only one had IgA nephropathy. At the same time, in 42 HBsAg+ cases the serum specimens were detected; 12 cases were positive for HBsAg, HBcAg and HBeAg, in whom serum HBV-DNA was positive, but only 5 were positive for HBV-DNA in renal biopsy tissue, and HBV-DNA was negative in other 30 blood serum and tissue specimens. Conclusions The difference in expression of HBsAg, HBcAb and HBeAg protein between IgA nephropathy and non-IgA nephropathy tissue from renal biopsy was not significant. There is no direct relationship between HBV infection and IgA nephropathy.