乙肝肾患儿血清、肾脏和肝脏组织内乙肝病毒感染标志物的比较

目的:比较分析乙型肝炎病毒相关性肾炎(HBV-GN)患儿血清、肾脏和肝脏组织内HBV感染标志物的表达情况。方法:45例血清HBV感染标志物阳性的HBV-GN患儿经肾脏组织活检确诊,其中13例同时进行肝脏组织活检,且行HBV感染标志物免疫组织化学检查。结果:45例HBV-GN肾脏病理改变为:膜性肾病(MN)25例(55.6%)、系膜增生性肾炎(MsPGN)11例(24.4%)、膜增生性肾炎(MPGN)5例(11.1%)、毛细血管内皮增生性肾炎(EPGN)4例(8.9%),免疫荧光检查显示肾脏组织内以IgG(40例,88.9%)和C3(34例,75.6%)沉积为主。血清HBV感染标志物HBeAg( )组25例(55.6%),HBeAg(-)组20例(44.4%);肾脏组织中HBcAg的阳性率为80.0%(36/45),其中,血清HBeAg(-)组肾脏组织HBcAg阳性率(100.0%)明显高于血清HBeAg( )组(64.0%),(P=0.002)。肝肾同检结果显示HBV感染标志物(HBsAg和HBcAg)在肝脏组织表达的阳性率分别为84.6%和53.8%,在肾脏组织表达的阳性率分别为84.6%和76.9%,且肝、肾组织中HBV感染标志物表达不同步。结论:HBV-GN患儿血清、肾脏和肝脏组织内HBV感染标志物表达呈明显的不一致性。

Comparison of HBV Markers in Serum,Kidney and Liver Tissue from Children with Hepatitis B Virus-Associated Glomerulonephritis

Objective:To compare with the presence of HBV markers in serum,renal and liver tissues from children with hepatitis B virus-associated glomerulonephritis(HBV-GN).Methods:45 cases of HBV-GN were confirmed by renal biopsy,13 of which were carried out liver biopsy simultaneously.The biopsy tissues were studied by immunohistochemical stain for markers of HBV.Results:Renal histology in these 45 cases showed membranous nephropathy 25 cases(55.6%),mesangial proliferative glomerulonephritis 11 cases(24.4%),membranoproliferative glomerulonephritis 5 cases(11.1%)and endocapillary proliferative glomerulonephritis 4 cases(8.9%).Immunofluorescence showed mainly IgG(40 cases,88.9%)and C3 deposit(34 cases,75.6%)in renal tissue.Serum HbeAg( )group accounted for 55.6%(25 cases),and HbeAg(-)group accounted for 44.4%(20 cases)in total 45 HBV-GN cases,HBcAg stain positive rate in renal tissue in serum HbeAg(-)group(100.0%)was significantly higher than that of HbeAg( )group(64.0%),(P=0.002).Meanwhile the expression of HBsAg and HBcAg in liver and renal tissue is not parallel.Conclusion:The expression of HBV markers in serum,renal and liver tissues in children with HBV-GN is not consistency.