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目的 :比较 Ig A肾病 (Ig AN)肾组织中乙型肝炎病毒抗原 (HBAg)阳性和阴性患者的临床与病理特点。 方法 :收集经免疫组化技术检测证实的肾组织 HBAg阳性组 2 6例和阴性组 59例 Ig AN患者的临床和病理及随访资料。 结果 :与阴性组相比 ,阳性组肾病综合征者多见 ,血红蛋白、血清 Ig A水平和肌酐清除率显著下降 ,2 4 h尿蛋白定量显著增加 (P<0 .0 5) ,免疫荧光以 Ig A+Ig G+Ig M型者多见 ,肾组织病理损害以 级为多 ,肾小球硬化、肾小管病变、间质炎症和纤维化程度均显著严重 ,随访期间 2例进入尿毒症期。 结论 :本组观察显示 ,肾组织中存在乙型肝炎病毒抗原的 Ig AN患者 ,临床病理改变较无乙型肝炎病毒抗原者重 ,预后差。
Objective: To compare the clinical and pathological features of hepatitis B virus antigen (HBAg) positive and negative renal tissues in patients with Ig A nephropathy (Ig AN). Methods: The clinical and pathological features and follow-up data of 26 IgAN positive patients and 26 negative IgAN patients were detected by immunohistochemistry. Results: Compared with the negative group, the nephrotic syndrome in the positive group was more common. The levels of hemoglobin, serum IgA and creatinine clearance were significantly decreased, while the 24 h urine protein was significantly increased (P <0.05). The immunofluorescence Ig A + Ig G + Ig M type more common, renal pathological lesions as grade, glomerular sclerosis, renal tubular lesions, interstitial inflammation and fibrosis were significantly more serious, 2 cases during follow-up into the uremic period . Conclusion: This group of observations show that patients with IgAN in the presence of hepatitis B virus antigen in renal tissue, clinical and pathological changes than those without hepatitis B virus antigen, the prognosis is poor.