尿HBsAg特异性免疫复合物检测在乙肝病毒相关肾炎中的临床意义

目的 探讨尿ＨＢｓＡｇ免疫复合物（ＩＣ）的检测在乙肝病毒相关肾炎中的诊断意义。方法 用ＰＥＧ沉淀结合胰蛋白酶解离法测定三组（Ａ组ｎ＝２１，Ｂ组ｎ＝９，Ｃ组ｎ＝１８）尿ＨＢｓＡｇ－ＩＣ，并与肾组织免疫荧光检测结果进行对比。结果 经肾活检确诊有ＨＢｓＡｇ肾沉积的１０例乙肝病毒相关肾炎中，尿ＨＢｓＡｇ－ＩＣ阳性检出率达９０％；非乙肝病毒相关肾炎（血ＨＢｓＡｇ阳性，无ＨＢｓＡｇ肾组织沉积）１０例中尿ＨＢｓ

The clinical significance of detecting urinary HBsAg immune complex in children with HBV associated glomerulonephritis

Objective To determine the correlation between the detection of urinary HBsAg immune complex (HBsAg IC) and deposition of HBsAg as well as immune reactants on glomeruli and to establish the diagnostic value of detecting HBsAg IC in children with HBV associated glomerulonephritis (HBV GN). Methods The study used the method of PEG precipitation combined splitting with trypsine and the technique of immunofluorescence to compare the results of detecting urinary HBsAg IC with the deposits of HBsAg, IgG, C 3 and electron density on glomeruli. Results The study showed a higher positive rate (90%) of urinary HBsAg IC in 10 children with HBV GN and a lower positive rate (10%) in 10 children with glomerular diseases without HBV deposition on glomeruli but HBV positive in serum. However, the positive rate of urinary HBsAg IC was 6% in healthy carriers of HBV. There was a positive correlation between urinary HBsAg IC and glomerular deposits of IgG, C 3, electron density. Conclusion The detection of urinary HBsAg IC may become a useful supplementary method for diagnosing HBV GN in children who could not receive renal biopsy.