肾组织中HBV的检出及其意义

目的：探讨HBsAg，HBcAg及HBV DNA在乙型肝炎病毒感染者肾脏组织中的表达情况及其意义。方法：对63例乙型肝炎病毒相关性肾炎（HBV-GN）患者、20例非乙型肝炎病毒相关性肾炎（NHBV-GN）患者、12例血清HBV标志阳性的其它肾病（肾结核、肾结石、肾细胞癌、肾萎缩等）患者用免疫组织化学方法检测肾穿刺活检组织HBsAg和HBcAg的表达；继而应用聚合酶链反应（PCR）技术对其阳性病例进一步检测肾组织HBV DNA。 结果： HBV-GN患者肾脏组织中均可检出HBsAg和HBcAg阳性颗粒，阳性率分别为76.2%(48/63)，42.9%(27/63)；20例NHBV-GN患者肾组织均未检出HBsAg和HBcAg，与HBV-GN患者相比有统计学意义(P<0.05)；12例肾病患者肾组织HBsAg和HBcAg阳性率均为66.7%，与HBV-GN患者相比无统计学意义(P>0.05)。血清HBeAg 阳性与血清HBeAg阴性的HBV-GN患者相比，肾脏组织中HBsAg和HBcAg表达情况差异无显著性 (P>0.05)。17例免疫组织化学阳性的HBV-GN患者肾组织检出HBV DNA 13例，阳性率为76.5%，8例免疫组织化学阳性的其它肾病患者肾组织检出HBV DNA 2例，阳性率为25%，两者比较有统计学意义(P<0.05)。结论：HBV定位肾脏，不仅可引起肾脏损害，并对病毒的复制、保存及乙型肝炎的传播有一定作用。

Presence and significance of HBV in renal tissuesfrom patients with HBV infection

Objective To investigate the presence and significance of HBsAg,HBcAg, and HBV DNA in renal tissues from patients with HBV infection. Methods The presences of HBsAg and HBcAg were measured in the renal tissues of 63 patients with HBV associated glomerulonephritis (HBV GN), 20 patients with non HBV associated glomerulonephritis (NHBV GN), and 12 other renal patients with positive HBV markers (such as renal tuberculosis, renal calculi, renal cellular carcinoma, and renal atrophy,and so on) by immunocytochemistry. HBV DNA was detected in the renal tissues of those patients with positive immunocytochemic results by polymerase chain reaction (PCR).Results HBsAg and HBcAg were present with the positive rates of 76.2% and 42.9% respectively in the renal tissues of HBV GN patients, which were significantly higher than those of NHBV GN patients, but had no statistical difference compared with those of other renal patients with positive HBV markers. The positive expression rates of HBsAg and HBcAg in renal tissues showed no statistically significant difference between HBV GN patients with positive serum HBeAg and HBV GN patients with negative serum HBeAg. By PCR, 13 out of 17 HBV GN patients (76.5%) were positive, and 2 out of 8 patients with other renal diseases (25%) were positive.Conclusion The location of HBV in the renal tissues may lead to renal lesions,and it plays a role in the replication, the preservation of virus, and the transmission of hepatitis B.