乙型肝炎病毒相关性肾炎T淋巴细胞的免疫病理学观察

对２８８例肾小球肾炎肾组织检测了ＨＢｃＡｇ、ＨＢｓＡｇ和ＨＢｅＡｇ的分布情况，并配对比较肾小管ＨＢｃＡｇ阳性组与阴性组各３８例中Ｔ淋巴细胞浸润与肾炎病变程度的关系。结果发现ＨＢｃＡｇ阳性组中ＣＤ３＋细胞和ＣＤ８＋细胞明显增多（Ｐ＜０．００１）。双重免疫酶标记染色证实Ｔ淋巴细胞直接侵入ＨＢｃＡｇ阳性之肾小管壁中。相应的ＨＥ染色亦观察到ＨＢｃＡｇ阳性组的肾炎病变程度明显重于阴性组（Ｐ＜０．０１）。认为除体液免疫损伤外，细胞免疫机制参与了乙型肝炎病毒相关性肾炎的发生和发展。

THE IMMUNOPATHOLOGICAL OBSERVATION OF T LYMPHOCYTES IN HEPATITIS B VIRUS ASSOCIATED GLOMERULONEPHRITIS

The locations of HBV antigens (HBcAg, HBsAg and HBeAg) in various types of HBV associated glomerulonephritis (BBV-GN) were identified in 288 renal biopsy specimens treated by immunohistochemical technique.Out of these specimens,38 pairs of matched tubular HBcAg positive and negative ones were sorted out to study the relationship between the T lymphocyte infiltration and the extent of GN lesions,By using CD McAb and double immunoenzymatic techniques,it was found that the numbers of CD3 and CD8 cells were evidently higher in the tubular HBcAg positive groups than in the negative ones (P<0.001),and that T cells invaded and even replaced the HBcAg positive tubular epithelium. Semiquantitative study on the corresponding HE-stained sections revealed the lesions,involving the tubules,glomeruli and interstitial tissue,were more serious in the tubular HBcAg positive groups than in the negative ones (p<0.01). These results indicate that cellular immunity participates in the development of HBVGN,beside the damage-causing humoral immune mechanism.