中国医药
中國醫藥
중국의약
CHINA MEDICINE
2012年
7期
836-838
,共3页
肾炎,乙型肝炎病毒相关性%肝炎,乙型%病理特点
腎炎,乙型肝炎病毒相關性%肝炎,乙型%病理特點
신염,을형간염병독상관성%간염,을형%병리특점
Glomerulonephritis,hepatitis B virus associated%Hepatitis B%Pathological characters
目的 探讨乙型肝炎病毒相关性肾炎(HBV-GN)的临床病理特点及治疗疗效.方法 分析经肾活检确诊的21例HBV-GN患者的病理特征、临床表现,检测乙型肝炎五项(HBsAg、抗-HBs、抗-HBc、HBeAg、抗-HBe)、24h尿蛋白定量,免组化染色检测肾组织中HBsAg和HBcAg,采用激素联合吗替麦考酚酯或来氟米特或环孢素治疗并评定疗效.结果 21例患者中男性18例,女性3例,男女比例为6:1;8例(38.1％)临床表现为肾病综合征;血清HBV-DNA阳性率为9.5％(2例);肾脏病理类型:膜性肾病8例(38.1％),系膜增生性肾小球肾炎6例(28.6％),IgA肾病4例(19.0％),膜增殖性肾小球肾炎3例(14.3％).肾组织HBsAg阳性、HBcAg阳性检出率分别为71.4％(15例)、85.7％(18例).7例激素联合来氟米特治疗的患者中,2例完全缓解,5例部分缓解.21例患者治疗后总有效率为85.7％( 18/21).结论 HBV-GN以男性多见,临床表现以肾病综合征最常见,病理类型以膜性肾病为主,激素联合来氟米特在HBV-GN治疗中有一定的作用.
目的 探討乙型肝炎病毒相關性腎炎(HBV-GN)的臨床病理特點及治療療效.方法 分析經腎活檢確診的21例HBV-GN患者的病理特徵、臨床錶現,檢測乙型肝炎五項(HBsAg、抗-HBs、抗-HBc、HBeAg、抗-HBe)、24h尿蛋白定量,免組化染色檢測腎組織中HBsAg和HBcAg,採用激素聯閤嗎替麥攷酚酯或來氟米特或環孢素治療併評定療效.結果 21例患者中男性18例,女性3例,男女比例為6:1;8例(38.1％)臨床錶現為腎病綜閤徵;血清HBV-DNA暘性率為9.5％(2例);腎髒病理類型:膜性腎病8例(38.1％),繫膜增生性腎小毬腎炎6例(28.6％),IgA腎病4例(19.0％),膜增殖性腎小毬腎炎3例(14.3％).腎組織HBsAg暘性、HBcAg暘性檢齣率分彆為71.4％(15例)、85.7％(18例).7例激素聯閤來氟米特治療的患者中,2例完全緩解,5例部分緩解.21例患者治療後總有效率為85.7％( 18/21).結論 HBV-GN以男性多見,臨床錶現以腎病綜閤徵最常見,病理類型以膜性腎病為主,激素聯閤來氟米特在HBV-GN治療中有一定的作用.
목적 탐토을형간염병독상관성신염(HBV-GN)적림상병리특점급치료료효.방법 분석경신활검학진적21례HBV-GN환자적병리특정、림상표현,검측을형간염오항(HBsAg、항-HBs、항-HBc、HBeAg、항-HBe)、24h뇨단백정량,면조화염색검측신조직중HBsAg화HBcAg,채용격소연합마체맥고분지혹래불미특혹배포소치료병평정료효.결과 21례환자중남성18례,녀성3례,남녀비례위6:1;8례(38.1％)림상표현위신병종합정;혈청HBV-DNA양성솔위9.5％(2례);신장병리류형:막성신병8례(38.1％),계막증생성신소구신염6례(28.6％),IgA신병4례(19.0％),막증식성신소구신염3례(14.3％).신조직HBsAg양성、HBcAg양성검출솔분별위71.4％(15례)、85.7％(18례).7례격소연합래불미특치료적환자중,2례완전완해,5례부분완해.21례환자치료후총유효솔위85.7％( 18/21).결론 HBV-GN이남성다견,림상표현이신병종합정최상견,병리류형이막성신병위주,격소연합래불미특재HBV-GN치료중유일정적작용.
Objective To explore the clinical features and curative effect of Hepatitis B virus associated glomerulonephritis(HBV-GN).Methods The pathology,clinical manifestation of 21 HBV-GN potients diagnosed by renal biopsy were analyzed.HBsAg,anty-HBs,anty-HBc,HBeAg,anti-HBe and urine protein in 24 hours were assayed.HBsAg and HBcAg of nephridial tissue were detected by immunohistochemical method.The treatment of hormone combined of mycophenolate mofetil or leflunomide,or ciclosporin A were used and the therapeulic effect was assessed.Results There were 21 patients diagnosed of HBV-GN.The ratio of male:female was 6:1.The clinical symptom of 8 patients(38.1％) was nephrotic syndrome and HBV-DNA positive rate was 9.5％(2/21).Of 21 cases,8 cases were with membranous glomerulonephrilis,6 cases with mesangial proliferative glomerulonephritis,4 cases with IgA nephropathy and 3 cases with membrane proliferative glomendonephritis.The positive rate of HBsAg and HBcAg in kidney tissues was 71.4％(15/21) and 85.7％(18/21).Of seven patients treated with hormone combined with leflunomide,the condition of 2 cases was complete remission,and others were partial remission.The total effective rate was 85.7％(18/21).Conclusions HBV-GN is more common in male.The most common clinical symptom is nephrotic syndrome,and membranous glomerulonephritis is the most frequent pathological type.Hormone combined leflunomide has some effect in the treatment of HBV-GN.
