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乙型肝炎病毒感染与肾小球肾炎 总被引:29,自引:0,他引:29
目的研究乙型肝炎病毒(HBV)感染与肾小球肾炎,尤其是与IgA肾病(IgAN)、狼疮肾炎(LN)间的关系,并初步观察α干扰素(αIFN)对成人乙肝相关性肾炎(HBVGN)的疗效。方法对157例肾活检标本采用免疫组织化学的方法检测肾组织中HBAg,配对比较32例IgAN,30例LN中HBAg阳性组与阴性组肾组织病理改变,和42例GN中HBcAg阳性组与阴性组对激素治疗的反应,并随访3例HBVGN经αIFN治疗的临床演变。结果IgAN中HBcAg阳性组肾小管及间质病变程度均较阴性组严重(P<005);LN中HBcAg阳性组肾小球硬化及间质炎症程度较阴性组显著(P<005);HBcAg阳性组对激素治疗的反应较阴性组差(P<005);3例HBVGN经αIFN治疗后临床症状缓解。结论肾小球肾炎部分病例起病与HBV感染有关,IgAN、LN与HBV感染有相关性,αIFN对成人HBVGN可能有良好的治疗作用。 相似文献
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张芳 《国际泌尿系统杂志》2006,26(4):562-566
药物相关性肾小球肾炎是一种免疫介导性疾病,其发病特点近年来被给予了高度关注。本文重点综述各种药物所致肾小球肾炎的病理类型、发病机制、临床表现、治疗及预后的最新进展。 相似文献
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肿瘤相关性肾小球肾炎 总被引:7,自引:0,他引:7
肿瘤相关性肾小球肾炎马大庆综述汪关煜董德长审校肿瘤的肾脏并发症已成为决定肿瘤病人预后的重要因素之一[1]。肿瘤可由多种形式引起肾脏损害,包括:(1)直接侵犯;(2)引起代谢紊乱如高钙血症等致肾脏损害;(3)肿瘤治疗并发症如放射性肾炎;(4)侵犯腹膜后... 相似文献
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肾小球肾炎是一种免疫性疾病,即免疫介导的以肾小球为主的炎症性病变。许多炎性因于在肾小球肾炎的病理反应中起重要的作用。随着分子免疫学与分子生物学技术的发展,对炎性因子的研究不断深入,炎性因子与抗炎性因子的相互作用可能决定了免疫介导的炎症性疾病的发生与发展。现将有关肾小球肾炎的免疫抑制治疗的研究进展综述如下。1IL-1受体拮抗剂 IL-1属多肽类生长因于,最初认为是单核一巨噬细胞产生的淋巴细胞激活因子。目前发现肾小球内皮细胞、系膜细胞及成纤维细胞等均可分泌IL-1。IL-1的生物学作用广泛,是一种多… 相似文献
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目的:探讨乙型肝炎病毒(HBV)感染对肾小球肾炎(GN)的致病作用.方法:应用免疫组织化学方法,检测49例血清HBV阳性和15例HBV阴性患者肾组织内HBV标志物(HBsAg、HBeAg、HBcAg)分布的状况,并对比两组患者的临床表现、化验检查和肾组织病理类型.结果:(1)两组在性别、年龄、24 h尿蛋白定量、合并血尿、肝功能受损、肾功能受损和血清免疫学指标方面无明显差异(P>0.05);(2)HBV标志物阳性组肾组织内HBV标志物检出率与阴性组相比无明显差异(P>0.05);(3)两组所致肾小球肾炎的病理类型方面无统计学差异(P>0.05).结论:HBV可能直接感染肾组织细胞导致肾炎的发生. 相似文献
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张暮寅 《国际泌尿系统杂志》2010,30(5)
乙型肝炎病毒相关性肾小球肾炎是继发性肾小球肾炎中较常见的一种.我国HBV感染率较高,HBV感染对肾脏的影响应引起重视.本文就乙型肝炎病毒相关性肾小球肾炎的诊断以及治疗进展作一综述. 相似文献
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Membranoproliferative glomerulonephritis associated with hepatitis C virus infection 总被引:11,自引:0,他引:11
Richard J. Johnson David R. Gretch Hideaki Yamabe Jaime Hart Carlos E. Bacchi Peter Hartwell William G. Couser Lawrence Corey Mark H. Wener Charles E. Alpers Richard Willson 《Pediatric nephrology (Berlin, Germany)》1993,7(5):528-528
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Matsumoto S Nakajima S Nakamura K Etani Y Hirai H Shimizu N Yokoyama H Kobayashi Y Tajiri H Shima M Okada S 《Pediatric nephrology (Berlin, Germany)》2000,15(3-4):271-273
We report on a 10-year-old girl with glomerulonephritis associated with hepatitis C virus infection, who was treated with
interferon-α. On the first renal biopsy at 8 years of age, mild mesangial hypercellularity in a segmental to semiglobal pattern
was present in all glomeruli. After 6 months interferon-α therapy, proteinuria diminished completely. However, mesangial proliferation
was advanced on the second biopsy at 10 years of age. We concluded that the interferon-α was effective in the treatment of
proteinuria despite the lack of pathological improvement.
Received: 15 March 2000 / Revised: 11 July 2000 / Accepted: 14 July 2000 相似文献
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Yao-Ko Wen 《International urology and nephrology》2010,42(2):477-485
Objectives
Infection-associated glomerulonephritis is uncommon in adults. In the present study, we have tried to determine the mode of presentation, the spectrum of morphology, and the prognostic factors for renal outcome in adult patients with infection-associated glomerulonephritis. 相似文献15.
The purpose of this study was to examine the influence of hepatitis C virus (HCV) infection on the occurrence of posttransplant de novo glomerulonephritis (GN). Of 165 patients selected for the study, 44 were HCV positive and 121 HCV negative. Light and immunofluorescence microscopy were performed on all biopsies and clinical and laboratory findings reviewed. Fifteen (34%) of the 44 HCV positive patients showed de novo GN (4 membranous, 11 membranoproliferative) at a mean of 47 +/- 22 months. But only 8 (6.6%) of 121 HCV negative patients showed de novo GN (5 anti-glomerular basement membrane nephritis in recipients with Alport's disease, 2 membranous GN, 1 membranoproliferative GN) at a mean of 60 +/- 39 months. The risk of development of de novo GN was higher among patients with HCV infection (P < .001). The presence of de novo GN in HCV positive patients impaired graft survival compared with HCV positive patients without de novo GN (P < .01). The incidence of recurrence of primary disease, mainly focal segmental glomerulosclerosis, membranous glomerulonephritis, membranoproliferative glomerulonephritis, and IgA nephropathy, was higher in HCV negative patients (29%) compared with HCV positive patients (6.8%; P = .001), namely, 50%, 57.6%, 25%, and 69%, respectively. In conclusion, HCV infection showed a strong influence on the development of de novo GN. For this reason, it is important to follow HCV positive recipients with a renal biopsy even when there are no significant clinical or laboratory findings. 相似文献
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Richard J JOHNSON Charles E ALPERS Catherine STEHMAN-BREEN Richard WILLSON William G COUSER 《Nephrology (Carlton, Vic.)》1995,1(1):11-16
Summary: Hepatitis C virus (HCV), in addition to causing both acute and chronic liver disease, may also be associated with several immunologically-mediated syndromes, particularly cryoglobulinaemia and membranoproliferative glomerulonephritis. Although the glomerulonephritis may be a feature of a systemic cryoglobulinaemic syndrome, it may also present as a primary renal disease without evidence of vasculitis or liver disease. Most of these latter patients, however, will have detectable cryoglobulinaemia either at the time of presentation or with continued observation. In this review, we discuss the pathogenesis of the glomerular disease. Most evidence supports the hypothesis that HCV associated glomerular disease results from the deposition of circulating immune complexes that are usually cryoprecipitable and which contain HCV, anti-HCV IgG, and rheumatoid factors. However, HCV antigens have yet to be identified in glomerular biopsies. This has raised the possibility that other pathogenic mechanisms may be involved, including auto-antibodies directed against glomerular antigens and factors related to chronic liver disease. Further studies are necessary to fully elucidate the pathogenesis of this recently recognized disease. 相似文献
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HBx基因是一种多功能的调节因子,具有广泛的反式激活作用,能激活转录因子、抑制DNA修复,并调节细胞的增殖、转化及凋亡.近年来,HBx在乙型肝炎病毒相关性肾炎(HBV-GN)致病中的作用成为研究的热点.研究显示,HBx对肾小球系膜细胞增殖、足细胞及肾小管上皮细胞的损伤及凋亡存在广泛影响.此文就HBx的生物学特性及在肾脏损伤机制中的研究进展进行了综述. 相似文献
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由于乙型肝炎病毒(HBV)的逆转录酶缺乏校正活性,在病毒复制过程中产生大量核苷酸错配,故HBV在宿主体内表现为大量在遗传学上高度相关而又有差别的病毒群体,这一群体称为准种,宿主体内的病毒准种在宿主免疫压力和药物的选择压力下不断发生动态变化,因此HBV准种变化在慢性乙型肝炎的抗病毒治疗、耐药检测以及预后等方面均有重要作用。本文对HBV准种变化与慢性乙型肝炎进展的关系作一综述。 相似文献
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Membranous glomerulonephritis and hepatitis B virus infection 总被引:2,自引:0,他引:2