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Lin对24例接受皮质激素治疗后,仍出现持续蛋白尿的乙型肝炎相关膜性肾病(HBVMN)患者进行研究。诊断标准为:1.肾活检光镜显示肾小球基膜增厚;免疫荧光染色见肾小球系膜中有HBsAG·HBcAG和HBcAg任一种呈弥漫性沉积;2.血清HBSAG阳性;3.尿检异常;4.无其他病毒感染。并有肾病综合征特点。作者先前发现用皮质激素治疗HBVMN患者未获得满意疗效。用和未用激素治疗的病人中,其巨噬细胞、T细胞和B细胞中存在3.2Kb的HBVDNA游记基因:“分子”。未用皮质激素治疗者,这些分子在12个月后消失,而用皮质激素治疗者3年后还在其T细胞中发现这种游离基因,并有频发的蛋白尿。结果提示使用皮质类固醇治疗
Lin studied 24 patients with persistent membranous albuminuria associated with membranous nephropathy (HBVMN) who remained corticosteroid-treated. Diagnostic criteria: 1. Renal biopsy showed glomerular basement membrane thickening; immunofluorescence staining showed mesangial mesangial HBsAG · HBcAG and HBcAg showed any diffuse deposition; 2. Serum HBSAG positive; 3 Urinalysis abnormalities; 4 no other virus infection. And nephrotic syndrome characteristics. The authors previously found no satisfactory response to treatment of HBVMN with corticosteroids. In patients treated with and without hormones, there is a 3.2 Kb HBVDNA travel marker: “molecule” in macrophages, T cells and B cells. Those not treated with corticosteroids disappeared after 12 months, whereas those treated with corticosteroids also found the free gene in their T cells three years later with frequent proteinuria. The results suggest corticosteroid therapy