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目的研究乙型肝炎病毒(HBV)感染与肾小球肾炎,尤其是与IgA肾病(IgAN)、狼疮肾炎(LN)间的关系,并初步观察α干扰素(αIFN)对成人乙肝相关性肾炎(HBVGN)的疗效。方法对157例肾活检标本采用免疫组织化学的方法检测肾组织中HBAg,配对比较32例IgAN,30例LN中HBAg阳性组与阴性组肾组织病理改变,和42例GN中HBcAg阳性组与阴性组对激素治疗的反应,并随访3例HBVGN经αIFN治疗的临床演变。结果IgAN中HBcAg阳性组肾小管及间质病变程度均较阴性组严重(P<005);LN中HBcAg阳性组肾小球硬化及间质炎症程度较阴性组显著(P<005);HBcAg阳性组对激素治疗的反应较阴性组差(P<005);3例HBVGN经αIFN治疗后临床症状缓解。结论肾小球肾炎部分病例起病与HBV感染有关,IgAN、LN与HBV感染有相关性,αIFN对成人HBVGN可能有良好的治疗作用。
Objective To study the relationship between hepatitis B virus (HBV) infection and glomerulonephritis, especially IgA nephropathy (IgAN) and lupus nephritis (LN), and to observe the relationship between interferon α (αIFN) and adult hepatitis B Nephritis (HBV GN) of the curative effect. Methods 157 cases of renal biopsy specimens were examined by immunohistochemical method of HBAg in renal tissue, matched with 32 cases of IgAN, 30 cases of LN in HBAg positive group and negative group, pathological changes of renal tissue, and 42 cases of HBcAg positive group and GN Group response to hormone therapy, and follow-up of 3 cases of HBV NG treatment by the α-IFN clinical evolution. Results The severity of tubulointerstitial lesions in HBcAg-positive group in IgAN was more serious than that in the negative group (P <005). The severity of glomerulosclerosis and interstitial inflammation in HBcAg-positive group was significantly higher than that in the negative group (P <005) ); HBcAg-positive group on the response to hormone therapy was worse than the negative group (P <0 05); 3 cases of HBV NG treatment by IFN clinical symptoms. Conclusion Some cases of glomerulonephritis onset and HBV infection, IgAN, LN and HBV infection have a correlation, α IFN may have a good therapeutic effect on HBV GN in adults.