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探讨乙型肝炎病毒 (HBV)感染与IgA肾病的关系。 方法 利用原位分子杂交、免疫组织化学及其双标记技术 ,部分病例辅以Southern印迹杂交和血清学检测 ,对 91例IgA肾病肾穿刺标本进行了系列研究。结果 肾组织内HBAg阳性率为 6 9% (6 3/ 91)。HBVDNA原位杂交阳性率为 43% (39/ 91)。作Southern印迹杂交检测的 2 7例中 ,18例 (6 7% )HBVDNA阳性 ,均属整合型 ,其中的 17例肾组织HBAg阳性 ,16例肾组织HBVDNA原位杂交阳性。肾小管上皮HBVDNA阳性病例 ,HBcAg及HBsAg的阳性率分别为 77% (30 / 39)及 72 % (2 8/ 39) ,HBVDNA阴性病例HBeAg和HBsAg阳性率分别为 10 % (5 /5 2 )及 2 1% (11/ 5 2 ) ,差别有显著意义 (P <0 .0 1) ,双重标记染色显示HBVDNA阳性病例的大部分半数以上HBVDNA阳性肾小管上皮细胞同时表达HBcAg和 (或 )HBsAg。结论 部分IgA肾病肾组织可以直接感染HBV ,并原位表达HBAg。
To investigate the relationship between hepatitis B virus (HBV) infection and IgA nephropathy. Methods In situ hybridization, immunohistochemistry and double labeling were used in this study. In addition, some cases were complemented by Southern blotting and serological tests. A series of 91 renal biopsy specimens from patients with IgA nephropathy were studied. Results The positive rate of HBAg in kidney was 69% (63/91). The positive rate of HBVDNA in situ hybridization was 43% (39/91). Of the 27 cases detected by Southern blotting, 18 (67%) were positive for HBVDNA, of which 17 cases were positive for HBAg and 16 cases were positive for HBVDNA by in situ hybridization. The positive rates of HBeAg and HBsAg in tubular epithelial cells were 77% (30/39) and 72% (28/39) respectively in HBVDNA-positive cases. The positive rates of HBeAg and HBsAg in HBVDNA negative cases were 10% (5/52) And 21% (11/52) respectively. There was a significant difference between the two groups (P <0.01). Double staining showed that most of HBVDNA positive cases had HBVDNA positive tubular epithelial cells expressing HBcAg and / or HBsAg at the same time . Conclusion Some IgA nephropathy kidney can directly infect HBV and express HBAg in situ.