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目的 :观察乙型肝炎病毒 (HBV)感染者肾组织中三种病毒抗原成分的分布特点及其与HBV感染状态和临床病理之间的联系 ,探讨在肾组织局部是否存在HBV的复制。 方法 :免疫组化法检测合并HBV感染的30例膜性肾病和 1 2例膜增生性肾炎病例的肾活检组织切片中的HBsAg、HBcAg和HBeAg ,同时检测肾小球和循环中的HBV基因组DNA及其复制中间体———闭合环状双链DNA(cccDNA)。 结果 :膜性肾病肾组织中病毒抗原的检出率 (83 3%)显著高于膜增生性肾炎 (33%) ;膜性肾病肾组织检出的抗原以HBcAg和HBeAg多见 ,其中 ,血清HBeAg阳性病例肾组织HBeAg的检出率显著高于HBeAg阴性的病例。膜增生性肾炎肾组织检出的抗原主要是HBeAg。肾组织HBeAg的检出与循环中HBeAg的存在明显相关。伴血清转氨酶升高者肾组织HBV抗原的检出率较转氨酶正常者有升高的趋势。肾小球HBVDNA和cccDNA的检出均与循环中的检测结果高度一致 ,并以伴活动性HBV感染者检出率为高。 结论 :在合并HBV感染的肾炎患者中 ,肾组织HBV抗原的检出率在膜性肾病患者明显高于膜增生性肾炎。肾小球中检出的HBV抗原成分以HBeAg和HBcAg最多见 ,肾小球HBeAg的检出与血清中是否存在HBeAg明显相关。合并肝功能损害者肾组织HBV抗原的检出率较肝功能正常者有增高趋势。在乙
OBJECTIVE: To investigate the distribution of three viral antigens in the kidney tissue of patients with hepatitis B virus (HBV) infection and their relationship with HBV infection status and clinicopathological features and to explore the existence of HBV replication in the kidney. Methods: Immunohistochemistry was used to detect HBsAg, HBcAg and HBeAg in renal biopsies of 30 patients with membranous nephropathy complicated with HBV infection and 12 patients with membranoproliferative glomerulonephritis. Meanwhile, HBV genomic DNA in glomeruli and circulation And its replication intermediates - closed circular double-stranded DNA (cccDNA). Results: The detection rate of viral antigen in membranous nephropathy was 83.3%, which was significantly higher than that in membranous nephritis (33%). The antigen in membranous nephropathy kidney was more common in HBcAg and HBeAg, HBeAg positive cases of renal tissue HBeAg detection rate was significantly higher than HBeAg-negative cases. Membrane proliferative glomerulonephritis renal tissue detected antigen is mainly HBeAg. Detection of renal tissue HBeAg and circulating HBeAg significantly correlated. The detection rate of HBV antigens in renal tissue with elevated serum aminotransferase was higher than that of normal transaminases. The detection of glomerular HBVDNA and cccDNA were highly consistent with the detection results in the circulation, and the detection rate of patients with active HBV infection was high. Conclusion: In the patients with nephritis complicated with HBV infection, the detection rate of HBV antigens in renal tissue is significantly higher in patients with membranous nephropathy than in patients with membranous proliferative glomerulonephritis. Detected in the glomerular antigenic components of HBV to HBeAg and HBcAg most common, the detection of glomerular HBeAg and serum HBeAg significantly correlated. The detection rate of HBV antigen in renal tissue with liver dysfunction was higher than that in normal liver function. In B.