IgA肾病是否与乙型肝炎病毒有关？

探讨ＩｇＡ肾病与乙型肝炎病毒的关系。方法采用免疫组化技术检测ＩｇＡ肾病患者肾组织中ＨＢＶ抗原及Ｓｏｕｒｔｈｅｒｎ印迹分子杂交技术检测肾组织中ＨＢＶＤＮＡ。结果８５例ＩｇＡ肾病患者血清ＨＢｓＡｇ阳性１５例（１７．６５％），肾组织ＨＢＶ抗原阳性２６例（３０．５９％），其中肾小球阳性１８例（５７．１４％），ＨＢｃＡｇ在肾小管和肾间质中阳性分别为９例（３４．６７％）和２例（７．６９％）；２例测肾组织ＨＢＶＤＮＡ，１例阳性；肾组织ＨＢＶ抗原阳性组比阴性组临床和病理改变更严重。结论乙型肝炎病毒与ＩｇＡ肾病的发病密切相关     

肾小球系膜增生机制的免疫组化研究

以单抗Ｍａｃ３８７作为单核细胞或中性粒细胞标志，以增殖细胞核抗原（ＰＣＮＡ）单抗作为细胞增殖指标，应用ＡＢＣ免疫酶标法对８７例各型肾小球肾炎肾穿刺组织进行了免疫组化研究，结果发现肾小球Ｍａｃ３８７阳性细胞数除紫癜性肾炎外，各型增生性肾炎显著高于非增生性肾炎（Ｐ〈０．０５）；ＰＣＮＡ阳性细胞数除ＩｇＡ肾炎外，各型增生性肾炎也均显著高于非增生性肾炎组（Ｐ〈０．０５）；肾小球Ｍａｃ３８７和ＰＣＮＡ阳性细     

狼疮肾炎患者血与尿白细胞介素-8测定的临床意义

目的　探讨血清和尿中白细胞介素８（ Ｉ Ｌ８） 水平变化在系统性红斑狼疮（ Ｓ Ｌ Ｅ） 及狼疮肾炎（ Ｌ Ｎ） 中的临床意义。方法　采用 Ｅ Ｌ Ｉ Ｓ Ａ 法对４７ 例 Ｓ Ｌ Ｅ 患者（ 含３７ 例 Ｌ Ｎ） 、１３ 例原发性慢性肾小球肾炎和１４ 例正常对照进行血清和尿中 Ｉ Ｌ８ 水平检测,比较分析其与 Ｓ Ｌ Ｅ 活动指数（ Ｓ Ｌ Ｅ Ｄ Ａ Ｉ） 、肾脏损害的相关关系。结果　 Ｓ Ｌ Ｅ 患者血清 Ｉ Ｌ８ 水平活动期为５５３ ｐｇ／ｍｌ（ 中位数,下同） 静止期为２６３８ ｐｇ／ｍｌ,明显高于正常对照组２０５４ ｐｇ／ｍｌ（ Ｐ ＜ ０００１） ,并且活动期高于静止期（ Ｐ ＜ ００５） ,血清 Ｉ Ｌ８ 水平与 Ｓ Ｌ Ｅ Ｄ Ａ Ｉ正相关（ ｒ ＝ ０６００３ , Ｐ ＜ ００５） ; Ｓ Ｌ Ｅ 患者尿 Ｉ Ｌ８ 显著高于正常对照组２０６７ｐｇ／ｍｌ（ Ｐ＜ ００５） ,且 Ｌ Ｎ 组２５２９ ｐｇ／ｍｌ 明显高于 Ｓ Ｌ Ｅ 无肾炎组为２１１ ｐｇ／ｍｌ 及原发性慢性肾小球肾炎组１９４１ ｐｇ／ｍｌ（ Ｐ 值均＜ ００５） ;肾脏组织病理狼疮活动指数（ Ａ Ｉ） 高者其血清、尿 Ｉ Ｌ８ 水平显著高于 Ａ Ｉ低者（ Ｐ ＜ ００５） 。结论　血清 Ｉ Ｌ     

bDNA定量检测血清乙型肝炎病毒DNA在肾炎中的应用

我国是乙型肝炎病毒（ＨＢＶ）感染高发区,ＨＢＶ感染可致急性肝炎、慢性肝炎、肝硬化、肝癌或引起肝外病变如乙型肝炎病毒相关性肾小球肾炎（ＨＢＶ－ＧＮ）等。α－干扰素（ＩＦＮ－α）作为一种有效的抗病毒手段已被广泛应用于慢性乙型肝炎,并被尝试用于治疗ＨＢＶ－ＧＮ［１］。分枝ＤＮＡ技术（ｂＤＮＡ）是血清ＨＢＶ　ＤＮＡ定量先进技术［２］。现将我科应用该技术在部分血ＨＢｓＡｇ（＋）肾炎患者中的诊疗经验总结如下。 一、对象和方法 １．对象：１９９７．６～１９９８．８期间在本科住院的各类肾小球肾炎伴血清ＨＢｓＡｇ（…     

肾组织中乙型肝炎病毒抗原阳性和阴性IgA肾病的临床与病理对照

目的比较ＩｇＡ肾病（ＩｇＡＮ）肾组织中乙型肝炎病毒抗原（ＨＢＡｇ）阳性和阴性患者的临床与病理特点。方法收集经免疫组化检测证实的肾组织ＨＢＶ抗原阳性组２６例和阴性组５９例ＩｇＡＮ患者的临床和病理及随访资料。结果与阴性组相比，阳性组肾病综合征者多见，血红蛋白、血ＩｇＡ水平和肌酐清除率显著下降，免疫荧光以ＩｇＡ＋ＩｇＧ＋ＩｇＭ型者多见，肾组织病理损害以Ⅳ级为多，肾小球硬化、肾小管病变、间质炎症和纤维化程度均显著严重。两组在临床表现、实验室检查、病理改变及预后方面均有显著性差异，阳性组临床病理改变更严重、预后更差。结论两组是性质相差较大的病变，对阳性组进行抗病毒治疗尤为重要     

尿中HBV-DNA检测在诊断乙型肝炎病毒相关性肾炎中的意义

自１９７１年Ｃｏｍｂｅｓ等首次报道１例乙肝相关膜性肾病后,ＨＢＶ感染与肾小球肾炎的关系已引起了各国学者的普遍关注。１９８９年我国学者正式将本病命名为乙型肝炎病毒相关性肾小球肾炎（ＨＢＶ－ＧＮ）。我们试就ＨＢＶ－ＧＮ患儿尿中能否检测到ＨＢＶ－ＤＮＡ及其对ＨＢＶ－ＧＮ的诊断意义进行初步探讨。 一、材料和方法 １．临床资料：１９９３－１９９９年本院收治的肾病患儿经临床检测血清ＨＢＳＡｇ或ＨＢＶ－ＤＮＡ阳性者３２例,均行肾活组织病理检查及活检组织ＨＢＶ－ＤＮＡ、ＨＢＶ－Ａｇ的检测,并运用原位杂交（ＩＳＨ）…     

心胸手术对乙型肝炎表面抗原阳性患者肝功能影响分析

为探讨心胸手术对乙型肝炎表面抗原（ＨＢｓＡｇ）阳性患者肝功能的影响，选择６０例手术患者，其中ＨＢ－ｓＡｇ阳性３０例（病例组），ＨＢｓＡｇ阴性３０例（对照组），于手术前后分别测定肝功能指标进行对比分析。结果显示：ＨＢｓＡｇ阳性患者谷丙转氨酶（ＧＰＴ）术后高于术前（Ｐ＜０．０１）；谷丙／谷草转氨酶比值（ＧＯＴ／ＧＰＴ）术后低于术前（Ｐ＜０．０５）；其中大三阳（ＨＢｓＡｇ、ＨＢｅＡｇ和抗－ＨＢｃＡｇ阳性）患者ＧＰＴ术后高于术前（Ｐ＜０．０５）。结论：心胸手术对ＨＢ－ｓＡｇ阳性患者肝功能有不同程度的损害作用，但并非手术绝对禁忌症。     

增殖性肾炎患者肾小球细胞胰岛素样生长因子—1的表达及其意义

目的　探讨人类增殖性肾炎（ＰＧＮ） 肾小球中胰岛素样生长因子１（ＩＧＦ１） 的表达及其意义。方法　采用原位杂交、免疫组织化学方法检测肾活检组织中ＩＧＦ１ ｍＲＮＡ及其蛋白质表达，并分析其与患者肾小球内细胞外基质（ＥＣＭ） 增生的关系。结果　增殖性肾炎组中ＩＧＦ１ 的表达水平显著高于非增殖性肾炎组和正常组（ Ｐ＜０－０１），ＩＧＦ１ 表达水平与ＥＣＭ 增生程度呈正相关。结论　肾小球局部ＩＧＦ１ 基因异常表达参与了ＰＧＮ的发病机制。     

原位杂交检测乙型肝炎病毒DNA在肾脏的存在

目的：探讨乙型肝炎病毒对肾脏的致病作用。方法：应用地高辛素标记的ＨＢＶ ＤＮＡ两种探针原位杂交，检测１５例乙型肝炎病毒相关性肾炎（ＨＧＶ－ＧＮ）患者肾活检石腊包埋切片ＨＢＶ ＤＮＡ。结果：ＩＳＨ采用ＨＢＶ ＤＮＡ全长段探针９／１５例阳性，其中５例阳性和４例阴性者再用ＨＢＶ ＤＮＡ Ｘ＋Ｃ段探针检查，各获１例阳性（２０％和２５％），阳性信号主要见于肾小管上皮细胞，其次是肾小球系膜细胞，呈胞浆型或核型     

体外免疫吸附对狼疮肾炎的治疗和保护作用

目的　观察体外免疫吸附（ＥＩＡ） 对狼疮肾炎（ＬＮ） 的治疗和肾脏保护作用。方法　比较树脂型ＥＩＡ、大剂量激素和ＣＴＸ联合治疗（ 简称ＥＩＡ组）与大剂量激素和ＣＴＸ治疗（ 简称对照组） 血ＩｇＧ、ＡＮＡ、ｄｓＤＮＡ、Ｃ３、２４ 小时尿蛋白、ＢＵＮ、Ｓｃｒ 及其他临床指标的变化。结果　治疗２ 周时,ＥＩＡ组血ＩｇＧ、ＡＮＡ、ｄｓＤＮＡ显著低于对照组［ 两组分别为ＩｇＧ（１０－０３ ±２－９１） 、（１３－５４ ±３－０５）ｇ／Ｌ,ＡＮＡ（１４－００ ±１３－１４）、（３１－８２ ±３０－０２）ｔｉｔｅｒ－ １,ｄｓＤＮＡ（８－３０ ±４－８３） 、（２７－００ ±１８－５１） ％］ 。Ｃ３ 显著回升［ 两组分别为（５８７－３±９７－０３） 、（４８１－５±１３２－０４）ｍｇ／Ｌ］,２４ 小时尿蛋白、ＢＵＮ、Ｓｃｒ 显著低于对照组［ 两组分别为２４ 小时尿蛋白（２－２８±２－０７） 、（５－９８ ±３－３４）ｇ／２４ｈ,ＢＵＮ（９－１７ ±２－８３）、（１５－２９ ±５－３８）ｍｍｏｌ／Ｌ、Ｓｃｒ（１５６－７５ ±８９－３３）、（２４７－１４±７４－６９）μｍｏｌ／Ｌ） 。治疗４ 周时,ＥＩＡ 组血ＩｇＧ、ｄｓＤＮＡ 仍低于对照组［ 两组分别为Ｉｇ     

乙型肝炎病毒DNA与IgA肾病发病的关系

目的：探讨乙型肝炎病毒(HBV)感染与IgA肾病发病的关系。方法：50例血清HBV标志或肾组织HBV抗原阳性的IgA。肾病患者作为研究对象，应用原位分子杂交技术和Souther blot技术检测肾组织中HBV DNA。结果：50例IgA肾病患者中，血清HBsAg阳性17例(34％)；肾组织HBAg阳性48例(96％)，HBAg在肾小球中阳性率为82％(41／50)，其中HBsAg为58％(29／50)，HBcAg为42％(21／50)；除了肾小球，47例(94％)患者BsAg和HBcAg。肾小管上皮细胞亦有阳性沉积，分别为28例(56％)和39例(78％)；原位分子杂交证实50例患者肾组织HBV DNA阳性率为92％(46／50)，其中肾小管上皮细胞、肾小球细胞HBV DNA阳性率分别为72％(36／50)和82％(41／50)。Southem blot技术证实在50例患者肾组织中34例有整合型HBV DNA，阳性率为68％。结论：HBV感染与IgA肾病的发病密切相关，HBV可能直接感染肾组织并原位表达HBV DNA而参与了IgA肾病的发病。     

68例伴有肾组织乙肝病毒抗原沉积的肾炎患者临床和病理分析

目的：探讨血清乙肝病毒（HBV）标志物与肾组织HBV抗原沉积、肾病理之间的关系，了解乙肝病毒相关性肾炎（HBV—GN）的临床和病理特点。方法：收集成人肾组织中检测到HBsAg和／或HBcAg沉积的肾炎患者68例（以下称沉积阳性组）。随机抽取同期肾穿合并有慢性乙型肝炎但肾组织中不伴HBsAg和／或HBcAg沉积的肾炎患者24例作为对照组（以下称沉积阴性组）。两组均采用间接免疫荧光法检测肾活检组织冰冻切片中HBsAg和HBcAg，荧光定量PCR法检测血清HBV—DNA水平。结果：（1）两组患者在血压、血尿和蛋白尿程度以及肾功能水平均无统计学差异；（2）沉积阳性组肾病理以IgA肾病（IgAN，占51．5％）和不典型膜性肾病（MN，占38．2％）为主；沉积阴性组则以系膜增生性肾炎（MsPGN，占50％）为主；（3）68例患者中13例血清HBV标志物阴性或仅有HBsAb阳性，血HBV—DNA病毒载量〈100拷贝／ml的患者肾组织中检测到HBsAg和俄HBcAg沉积，且免疫荧光显示免疫球蛋白和补体沉积均在3种以上，满堂亮者7例（53．8％）：光镜显示不典型MN9例（69．2％），IgAN3例，MPGN1例。结论：对于成年人依据临床难作出HBV—GN诊断。成人HBV—GN病理表现具有多样性，以IgAN和不典型MN为主，其次为MPGN和MsPGN，FSGS少见；肾组织HBV抗原沉积现象可以出现在血清HBV标志物阴性或仅HBsAb阳性的患者，提示应重视肾组织HBV抗原检测，尽可能降低HBV—GN的漏诊率，尤其是血清HBV标志物阴性的患者。     

Positive and negative hepatitis B virus in renal biopsies of IgA nephropathy: an 85-case clinicopathological analysis

SUMMARY: The aetiological role of hepatitis B virus (HBV) antigens in IgA nephropathy remains uncertain. In a clinicopathological study, we examined 85 patients with primary IgA nephropathy divided into two groups depending on whether renal biopsy specimens were positive or negative for HBV antigens (HBsAg, HBcAg and HBeAg) using immunohistochemical methods. Compared with patients in the negative group ( n = 59), those in the positive group ( n = 26) had more obvious gross haematuria, proteinuria, hypertension and renal impairment. Their haemoglobin level, serum IgA concentration and creatinine clearance were also significantly abnormal. Immunofluorescence microscopy indicated that immunoglobulins deposited were mainly found in the combination of IgA + IgG + IgM. Consistent with the clinical manifestations, the pathological lesions revealed more glomerular sclerosis, tubular epithelial degeneration and necrosis and interstitial inflammation and fibrosis ( P < 0.05). Thus, we concluded that the presence or absence of HBV in renal tissue from patients with IgA nephropathy results in significant differences in the clinical features, types and severity of pathological lesions and, consequently, prognosis. Tissue deposition of HBV might play an aetiological role in the pathogenesis of IgA nephropathy and may be an exacerbating factor in renal progressive deterioration. Antiviral therapy could be an important intervention in HBV antigen-positive patients.     

乙型肝炎病毒感染在IgA肾病发病中的作用的进一步研究

目的：探讨乙型肝炎病毒（HBV）感染与IgA肾病发病的关系。方法：采用免疫组化技术检测168例IgA肾病患者肾组织中HBV抗原（HBAe）,应用原位分子杂交技术和Southern印迹杂交技术检测95例IgA肾病患者肾组织中HBVDNA。结果：168例IgA肾病患者中,血清HBsAg阳性32例（19．05％）;肾组织HBAg阳性59例（35．12％）,HBAg在肾小球中阳性率为30．36％（51／168）,其中HBsAg为27．98％（47／168）,HBcAg为24．40％（41／168）;除了肾小球,H13sA4g和HBcAg肾小管上皮细胞亦有阳性沉积,分别为44例（26．19％）和48例（28．57％）;Smthem印迹杂交证实在95例患者肾组织中46例有整合型HBVDNA,阳性率为48．42％;原位分子杂交证实95例患者肾组织HBVDNA阳性率为52．63％（50／95）,其中肾小管上皮细胞、肾小球细胞和肾间质浸润的淋巴细胞HBVDNA阳性率分别为49．47％（47／95）、45．26％（43／95）和33．68％（32／95）;其中18例患者肾组织中HBVDNA同时定位于肾小管上皮细胞、肾小球系膜细胞和少数间质淋巴细胞的细胞核中。结论：除了HBV抗原、抗体复合物所致体液免疫损伤外,也要考虑肾组织直接感染HBV,并参与了IgA肾病的发病。     

Severity of nephrotic IgA nephropathy according to the Oxford classification

Background

IgA nephropathy with nephrotic syndrome (nephrotic IgAN) is a rare form of IgAN. Its prognosis and response to steroid therapy are still controversial because the differential diagnosis between nephrotic IgAN and minimal change nephrotic syndrome with IgA depositions is sometimes confused.

Methods

In this retrospective cohort analysis, we accurately diagnosed 42 cases of nephrotic IgAN (4.4%) from 954 IgAN patients, according to the Oxford classification. We analyzed the clinical and histological data, prognosis, and response to steroid therapy.

Results

In nephrotic IgAN, mean estimated glomerular filtration rate (eGFR) was 51.1?±?24.6?ml/min, proteinuria was 5.71?±?2.56?g/day, and urinary red blood cells were 51.0?±?37.8 high power field. Both active and chronic histological lesions were observed. Cumulative renal survival rate was significantly lower in nephrotic IgAN than in non-nephrotic IgAN (the control group consisted of 47 non-nephrotic IgAN patients diagnosed between 1995 and 1996) (log-rank test: P?Conclusion Nephrotic IgAN is a very severe form of IgAN, with renal dysfunction, massive hematuria, and active and chronic histopathological lesions. Renal outcome is severe; however, steroid therapy can improve prognosis in cases with higher eGFR and lower T-grade, according to the Oxford classification.     

Clinical significance of histological grading and staging for predicting the effectiveness of steroid therapy in IgA nephropathy

Background. A beneficial effect of steroid therapy for IgA nephropathy (IgAN) has been reported. However, precise histological criteria for steroid therapy have not yet been established. The present study was designed to assess the clinical validity of histological grading and staging for predicting the responsiveness to steroid therapy in IgAN. Methods. We performed a retrospective study of 27 patients with IgAN who underwent steroid therapy. The duration of steroid therapy was 42.9 ± 23.1 months, and the mean follow-up period was 7.5 ± 2.4 years, ranging from 4 to 14 years. Responsiveness to the steroid therapy was evaluated by reduction of urinary protein at 1 year after treatment; more than 50% reduction of initial urinary protein and less than 1.0 g/day. Responsiveness to the therapy was also evaluated by preservation of renal function; i.e., maintenance of serum creatinine level under 2.0 mg/dl during follow-up. The histological grading and staging method (G-S system) proposed by Shigematsu was used to evaluate the histological severity of lesions in renal biopsy specimens. Univariate analyses of clinical and histological parameters, using the logistic regression model or Cox proportional hazards model, were performed to find predictive factors for the effectiveness of steroid therapy. Results. No clinical parameters at the start of treatment predicted the effectiveness of the steroid therapy. However, some histological parameters – crescent formation rate (%), grade of glomerular extracapillary lesions (Gex) and grades of acute and chronic interstitial inflammation (Gint and Sint) – were predictive for the effectiveness of steroid therapy. To predict reduction of proteinuria at 1 year after steroid therapy, the crescent formation rate, Gex, Gint, and Sint were significant (odds ratio; P value): crescent formation rate per 10% increment (2.91; P = 0.019), Gex per 0.1 grade increment (1.56; P = 0.021), Gint per one grade increment (0.20; P = 0.022), and Sint per one grade increment (0.33; P = 0.039). These results indicated that a high crescent formation rate and active extracapillary lesions predicted favorable response, and active and chronic interstitial lesions predicted lower efficacy in proteinuria reduction. To predict deterioration of renal function, Gint and Sint were significant (hazard ratio; P value): Gint per one grade increment (3.30; P = 0.015) and Sint per one grade increment (2.99; P = 0.006), indicating that high degrees of acute and chronic interstitial inflammation predicted the deterioration of renal function. Conclusions. The severity of acute glomerular extracapillary lesions predicts the possibility of reduction in proteinuria after steroid therapy, while the severity of interstitial inflammation suggests a lower efficacy for proteinuria reduction and a high risk of renal dysfunction even after steroid therapy in IgAN. Received: August 17, 1999 / Accepted: May 8, 2000     

PEG-干扰素α-2a治疗低转氨酶乙型肝炎患者的回顾性研究

目的对于PEG-干扰素α-2a（PEG—IFNα-2a）治疗的低转氨酶水平慢性乙型肝炎患者进行回顾性研究。方法对治疗满48周并于治疗前完成肝活检的乙型肝炎患者,取用药后第12周、24周、48周为观察点,记录乙型肝炎病毒血清标志物与HBVDNA的变化情况,并分析其应答与肝组织炎症程度（G分级）、肝细胞HBcAg分布的相关程度。结果按炎症级别分组之HBeAg阳性组：治疗48周时G1组总有效率20％（2／10）,G2组总有效率56．25％（9／16）,G3组100％（6／6）;HBeAg阴性组炎症级别G1组10％（1／10）,G2组62．5％（5／8）,G3组100％（2／2）。按照肝细胞HBcAg表达分组之HBeAg阳性组：48周时浆型表达总有效率80％（8／10）,混合型表达组总有效率42．1％（8／19）,阴性表达组100％（3／3）。HBeAg阴性组：浆型分布组DNA阴转率为37．5％（3／8）,混合型组为28．57％（2／7）,阴性组为60％。结论无论按照炎症还是肝细胞HBcAg表达分组比较,最初统计学处理后发现各个级别分组所得数据未见明显差异（包括HBeAg阳性与阴性组）。加入时间因素后显示随时间延长,高炎症水平、HBcAg的阴性表达和（或）浆型表达会有更高的疗效。     

The existence and significance of hepatitis B virus DNA in glomerulonephritis

Summary: In order to investigate the role of hepatitis B virus (HBV) in the pathogenesis of glomerulonephritis 50 cases of glomerulonephritis with HBV antigenaemia and/or hepatitis B antigen (HBAg) detected by immunohistochemistry in renal tissue were collected. the distribution and localization of HBV DNA were observed by using in situ hybridization. In addition, Southern blot analysis was performed on 23 of the 50 cases in order to reveal the state of renal HBV DNA. Thirty-six cases (72%) were found to be HBV DNA positive by in situ hybridization, which localized in the nucleus of tubular cells. In 26 cases HBV DNA was detectable in the nucleus of glomerular mesangial and epithelial cells as well as the mesangial matrix. Seventeen of the 23 cases were proved to be HBV DNA positive in Southern blot analysis (82%). Three of these cases were identified with non-replicating free HBV DNA, while 14 cases were the integrated form. the results of this study showed that the renal tissue was infected with HBV; however, it was considered that it may be possible that the HBAg deposited on glomeruli was not only from circulation but also from the HBV infected glomerular cells although the evidence of this is not conclusive. In addition to the humoral immune injury mediated by HBAg-hepatitis B antibody (HBAb) immune complexes the cellular immune injury mediated by target antigen (hepatitis B core antigen; HBcAg) might be also involved in the pathogenesis of HBV glomerulonephritis (GN) associated GN.     

乙型肝炎病毒相关性肾炎患者临床与病理的关系

目的探讨乙型肝炎病毒相关性肾炎（HBV-GN）患者临床与病理的关系。方法回顾性分析经肾活检确诊的52例HBV—GN患者的肝功能、肾功能、血脂、24h尿蛋白定量、乙型肝炎病毒标志物HBV-DNA等,应用乙肝免疫组织化学方法检测40例血清乙型肝炎病毒（HBV）阳性和12例HBV阴性患者肾组织中乙型肝炎病毒表面抗原（HBsAg）、乙型肝炎病毒核心抗原（HBcAg）和乙型肝炎病毒e抗原（HBeAg）,对比两组患者的临床表现和肾组织病变特征。结果HBV阳性的临床表现以肾病综合征最多见（38例,72％）,病理类型以膜增殖性肾炎（16例,40％）和重度系膜增生性肾炎12例（30％）多见。两组之间的临床表现和肾组织病理类型无显著性差异（P〉0．05）。HBV抗原除在肾小球沉积外,肾小管常有阳性表达,尤其肝功能异常和HBV-DNA阳性者HBcAg肾小管阳性率达36％,高于肾小球的21％,有显著性差异（P〈0．05）。血清HBeAg阳性者肾小球HBeAg的检出率显著高于血清HBeAg阴性者（P〈0．05）。结论HBVGN的临床表现、病理类型与原发性肾小球疾病类似。HBV可能直接感染肾组织导致HBV-GN的发生。肾小球HBeAg与血清HBeAg阳性者呈正相关。