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目的分析影响慢性乙型肝炎患者发生HBV相关性肾炎的关联因素。方法慢性乙型肝炎患者144例肾穿刺活检诊断为HBV相关性肾炎70例(HBV-GN组)和乙型肝炎感染合并肾炎74例(非HBV-GN组),分析两组患者临床病理指标。结果临床表现:HBV-GN组以肾病综合征为主33例(47.14%),非HBV-GN组以蛋白尿伴血尿及单纯血尿为主41例(55.41%)。病理类型:HBV-GN组以膜性肾病为主29例(41.43%),非HBV-GN组以IgA肾病为主29例(39.19%)。临床指标:HBV-GN组乙型肝炎病毒复制率和HBeAg阳性率均高于非HBV-GN组(60.00%vs.40.54%和2、30.00%vs.9.46%)(P<0.05);血清ALT、白蛋白、IgG及24-h尿蛋白定量两组间有统计学差异。结论男性、HBV DNA复制、HBeAg阳性、ALT升高、低血清IgG水平、大量蛋白尿提示HBV肾脏损害是以HBV相关性肾炎可能性大。
Objective To analyze the related factors affecting HBV-associated nephritis in patients with chronic hepatitis B Methods Seventy-four patients with chronic hepatitis B who were diagnosed by renal biopsy were diagnosed as HBV-related nephritis in 70 cases (HBV-GN group) and 74 cases with hepatitis B infection combined nephritis (non-HBV-GN group), and the clinicopathological parameters were analyzed. Results The clinical manifestations: nephrotic syndrome in the group of HBV-GN 33 cases (47.14%), non-HBV-GN group with proteinuria with hematuria and hematuria in 41 cases (55.41%). The pathological type: 29 cases (41.43%) were mainly membranous nephropathy in HBV-GN group and 29 cases (39.19%) were mainly IgA nephropathy in non-HBV-GN group. Clinical indicators: The positive rate of hepatitis B virus and HBeAg in HBV-GN group were significantly higher than those in non-HBV-GN group (60.00% vs. 40.54% and 2,30.00% vs 9.46%, respectively) (P <0.05) , Albumin, IgG and 24-h urine protein were statistically significant differences between the two groups. Conclusions Male patients with HBV DNA replication, HBeAg positive, elevated ALT, low serum IgG levels, and large amounts of proteinuria suggest that HBV-induced nephritis is more likely to be associated with HBV-induced kidney damage.