乙型肝炎病毒感染在IgA肾病发病中的作用

目的 探讨乙型肝炎病毒（HBV）感染与IgA肾病的关系。方法 采用免疫组化技术检测肾组织HBV抗原（HBAg),应用原位分子杂交技术和Southern印迹杂交技术检测肾组织HBV DNA。结果 100例IgA肾病患者中,血清HBsAg阳性18例（18％）;肾组织HBAg阳性31例（31％）,HBAg在肾小球中阳性率为65％（20／31）,其中HBsAg为32％（10／31）,HBcAg为32％（10／31）;除肾小球外,HBcAg在肾小管上皮细胞和肾间质亦有阳性沉积,分别为14例（45％）和2例（6％）;Southern印迹杂交证实6例患者中5例肾组织有整合型HBV DNA;原位分子杂交证实肾小管和肾小球中HBV DNA阳性率分别为100％（8／8）和75％（6／8）;定位于肾小管上皮细胞、肾小球细胞和肾间质浸润的淋巴细胞中。结论 HBV感染与IgA肾病密切相关,HBV可能参与了IgA肾病的发病过程。

Role of hepatitis B virus infection in pathogenesis of IgA nephropathy

Objective To clarify the relationship between hepatitis B virus (HBV) infection and IgA nephropathy (IgAN) Methods HBV antigen (HBAg) in renal tissues of the patients with IgAN was detected by immunohistochemical technique, the carrier status and localization of HBV DNA in renal tissues were determined by Southern blot analysis and in situ hybridization Results Serum HBsAg was detected in 18 of the 100 patients with IgAN (18%), HBAg was detected in 31 of 100 patients (31%) in their renal tissue and in 20 of 31 patients (65%) in their glomeruli, and both HBsAg and HBcAg were detected in 10 of 31 patients (32%), respectively HBcAg was also found in tubular epithelia (45%, 14/31) and renal interstitium (6%, 2/31), respectively Five of six cases were proved to be positive of integrated form HBV DNA in their renal tissue by Southern blot analysis In situ hybridization demonstrated that HBV DNA was 8/8 and 6/8 positive in their renal tubules and glomeruli of all eight specimens, localized in the nucleus of tubular epithelial cells, glomerular mesangial cells, as well as infiltrated interstitial lymphocytes Conclusion HBV infection closely related with IgAN and HBV infection might be involved in pathogenesis of IgAN