乙肝病毒感染与乙肝病毒相关性肾炎间的关系分析

目的 探讨研究乙肝病毒(HBV)感染与乙肝病毒相关性肾炎之间的关系.方法 对124例资料完整的HBV相关肾炎(HBV-related glomerulonephritis,HBV-GN,)患者的血清病毒学、肾脏及肝脏病理学和常规实验室检查结果进行回顾分析研究.结果 124例血清HBsAg和/或HBeAg阳性的患者中,HBV-GN的发生率69.49％,男性发生率(45.0％)显著高于女性(24.49％),P＜0.05.血清HBeAg阳性组HBV-GN的发生率显著高于HBeAg阴性组.HBV DNA定量＞105 copies/mL组HBV-GN的发生率亦显著高于定量＜105 copies/mL组.HBV-GN患者血清HBeAg阳性与阴性组之间比较,24小时尿蛋白定量及内生肌醉清除率均无显著差异.血清HBV DNA定量＞105copies/mL组与定量＜ 105 copies/mL组之间比较24小时尿蛋白定量与内生肌酐清除率亦无显著差异.HBV-GN患者肾组织局部HBcAg沉积阳性组与阴性组相比较,24小时尿蛋白定量有显著性差异(P＜0.05),而内生肌酐清除率无显著性差异.结论 HBV感染及其复制状态与HBV-GN的发生密切相关;但HBV的复制状态可能并不明显影响HBV-GN患者肾、肝组织的病变程度.

Analysis of the relationship etween hepatitis B virus infection and the hepatitis B virus associated glomerulonephritis

Objective To study on the relationship between hepatitis B virus (HBV) infection and HBV associated glomerulonephritis (HBV-GN).Methods Serum virological information, kidney and liver pathology results and routine laboratory test results of 124 HBV-GN patients were collected and analyzed.Results Among 124 patients who were serum HBsAg and/or HBeAg positive, the incidence of HBV-GN was 69.49％, and the incidence in male (45.0％) was significantly higher than the females (24.49％, P ＜ 0.05).The serum HBV-GN positive rate in HBeAg positive group was significantly higher than that of HBeAg negative group.The incidence of HBV-GN among patients with HBV DNA titer over 105 copies/mL was also significantly higher than the patients with HBV DNA titer of ＜ 105 copies/mL.The 24-hours urinary protein excretion within endogenous creatinine clearance rate of HBV-GN patients showed no significant difference between serum HBeAg positive and negative groups.The 24-hours urinary protein excretion and endogenous creatinine clearance rate showed no significant difference between patients with HBV DNA titer over 105 copies/mL and the patients with HBV DNA titer of ＜ 105 copies/mL.The 24-hours urinary protein excretion showed significantly different (P ＜ 0.05) between HBV-GN patients with localized positive and negative HBcAg deposition in renal tissue, while the endogenous creatinine clearance rate showed no significant difference between both types of patients.Conclusions HBV infection and replication status are closely related to the incidence of HBV-GN.HBV replication status does not seem to significantly affect the severity of renal tissue HBV-GN.