50例乙肝病毒相关性肾炎病例分析

目的总结近5年来乙肝病毒相关性肾炎（HBV—GN）的临床资料，探讨其临床表现、检验结果及治疗方法。方法分析50例临床资料的临床表现、检验结果，观察抗乙肝病毒药物（核苷类似物或干扰素α）及保护肾脏功能药物血管紧张素转换酶抑制剂（ACEI类）和血管紧张素Ⅱ受体阻滞剂（ARB类）对HBV—GN的治疗效果。结果临床表现以肾病综合征、镜下血尿为多见，各占70％、30％；膜性肾病占76％，膜增殖性肾炎占24％；肝功能除白蛋白外其余项目正常的占78％；凝血功能正常者占92％；治疗后水肿消失者占全部水肿患者的86％，尿蛋白减少者占全部有蛋白尿患者的83％。结论伴随肾脏损害的乙肝患者肝脏损伤发展较单纯乙肝患者慢；抗病毒结合保护肾脏功能对乙肝相关性肾炎疗效确切。

Analysis of 50 cases with HBV-Associated Glomerulonephritis

Objective To explore the clinical manifestation, check result and therapy of HBV - GN. Methods The clinical manifestation and check result were compared. The curative effects of alpha - interferon （ IFNα ） , ARB and ACEI for hepatitis B virus associated glomemlonephritis （ HBV - GN ） were observed. Results The common clinical situation were nephritiesyn - drome （NS） and microscopic hematuria, the ratio were 70% and 30% respectively; The constituent ratio of membranous nephropathy （MGN） and mesangioeapillary glomemlonephritis（MPGN） were 76% and 24% respectively; The ratio was 78% of normal liver function except albumin; The ratio was 92% of normal blood coagulation; The edema disappeared rate in the total number of patients with edema was 86% and the urine protein reduced was 83%. Conclusion Development of liver damage to patients with HBV - GN is slower than patients without HBV - GN ; It may be useful that the treatment with antiviras and protecting kidney function for patients with HBV - GN.