浙江医学
浙江醫學
절강의학
ZHEJIANG MEDICAL JOURNAL
2014年
1期
12-15
,共4页
汤绚丽%孙琳%朱晓玲%胡云琴%闵曼
湯絢麗%孫琳%硃曉玲%鬍雲琴%閔曼
탕현려%손림%주효령%호운금%민만
乙肝抗原血症%乙肝相关性肾小球肾炎%免疫荧光法%改良免疫组化法
乙肝抗原血癥%乙肝相關性腎小毬腎炎%免疫熒光法%改良免疫組化法
을간항원혈증%을간상관성신소구신염%면역형광법%개량면역조화법
HBV antigenemia%HBV associated glomerulonephritis%Indirect immunofluorescent staining%Improved immunohistochemical staining
目的：探讨不同染色方法检测HBsAg阳性患者肾组织中乙肝抗原的效果。方法收集血清HBsAg阳性的肾穿刺患者77例，分别采用免疫荧光法和改良免疫组化法检测肾组织HBsAg及HBcAg阳性表达情况。结果继发于乙肝病毒感染相关的肾小球肾炎（HBV- GN）中，HBsAg免疫荧光法及改良免疫组化法敏感性为48.1%及100%；HBcAg免疫荧光法及改良免疫组化法敏感性为22.2%及70.4%，差异均有统计学意义（均P＜0.01）。非乙肝相关性肾小球肾炎（NHBV- GN）中，HBsAg免疫荧光法及改良免疫组化法特异性为98%及96%；HBcAg免疫荧光法及改良免疫组化法特异性为100%及96%，两种方法特异性均较高，差异均无统计学意义（均P＞0.05）。乙肝抗原血症者肾组织HBsAg及HBcAg改良免疫组化法平均阳性强度明显高于免疫荧光法（P＜0.01）。血清乙肝“大三阳”、DNA复制者HBsAg改良免疫组化法检测阳性强度均明显高于“小三阳”及DNA不复制者（P＜0.05或0.01）。结论改良免疫组化染色法提高了乙肝抗原血症者肾组织乙肝抗原的检出率及肾小球疾病尤其是HBV- GN诊断的准确性，同时HBsAg阳性强度还可预测乙肝感染严重程度。
目的：探討不同染色方法檢測HBsAg暘性患者腎組織中乙肝抗原的效果。方法收集血清HBsAg暘性的腎穿刺患者77例，分彆採用免疫熒光法和改良免疫組化法檢測腎組織HBsAg及HBcAg暘性錶達情況。結果繼髮于乙肝病毒感染相關的腎小毬腎炎（HBV- GN）中，HBsAg免疫熒光法及改良免疫組化法敏感性為48.1%及100%；HBcAg免疫熒光法及改良免疫組化法敏感性為22.2%及70.4%，差異均有統計學意義（均P＜0.01）。非乙肝相關性腎小毬腎炎（NHBV- GN）中，HBsAg免疫熒光法及改良免疫組化法特異性為98%及96%；HBcAg免疫熒光法及改良免疫組化法特異性為100%及96%，兩種方法特異性均較高，差異均無統計學意義（均P＞0.05）。乙肝抗原血癥者腎組織HBsAg及HBcAg改良免疫組化法平均暘性彊度明顯高于免疫熒光法（P＜0.01）。血清乙肝“大三暘”、DNA複製者HBsAg改良免疫組化法檢測暘性彊度均明顯高于“小三暘”及DNA不複製者（P＜0.05或0.01）。結論改良免疫組化染色法提高瞭乙肝抗原血癥者腎組織乙肝抗原的檢齣率及腎小毬疾病尤其是HBV- GN診斷的準確性，同時HBsAg暘性彊度還可預測乙肝感染嚴重程度。
목적：탐토불동염색방법검측HBsAg양성환자신조직중을간항원적효과。방법수집혈청HBsAg양성적신천자환자77례，분별채용면역형광법화개량면역조화법검측신조직HBsAg급HBcAg양성표체정황。결과계발우을간병독감염상관적신소구신염（HBV- GN）중，HBsAg면역형광법급개량면역조화법민감성위48.1%급100%；HBcAg면역형광법급개량면역조화법민감성위22.2%급70.4%，차이균유통계학의의（균P＜0.01）。비을간상관성신소구신염（NHBV- GN）중，HBsAg면역형광법급개량면역조화법특이성위98%급96%；HBcAg면역형광법급개량면역조화법특이성위100%급96%，량충방법특이성균교고，차이균무통계학의의（균P＞0.05）。을간항원혈증자신조직HBsAg급HBcAg개량면역조화법평균양성강도명현고우면역형광법（P＜0.01）。혈청을간“대삼양”、DNA복제자HBsAg개량면역조화법검측양성강도균명현고우“소삼양”급DNA불복제자（P＜0.05혹0.01）。결론개량면역조화염색법제고료을간항원혈증자신조직을간항원적검출솔급신소구질병우기시HBV- GN진단적준학성，동시HBsAg양성강도환가예측을간감염엄중정도。
Objective To compare two immunochemical methods in detection of HBsAg and HBcAg in renal biopsy specimens. Methods Renal biopsy samples were taken from 77 HBsAg positive patients with nephritis. HBsAg and HBcAg in renal tissue were detected by indirect immunofluorescent staining (IIFS) and improved immunohistochemical staining (IIHS), re-spectively. Results In patients with hepatitis B virus- related glomerular nephritis(HBV- GN) the sensitivity of HBsAg detected by IIHS and IIFS was 100.0% and 48.1%, respectively (P<0.01); that of HBcAg was70.4% and 22.2%, respectively (P<0.01). In non- HBV- GN patients, the specificity of HBsAg detected by IIFS and IIHS was 98.0% and 96.0% respectively, while that of HBcAg was 100.0%and 96.0%(P>0.05). The intensity score of HBsAg was 0.15 by IIFS and 0.74 by IIHS, while that of HBcAg was 0.04 by IIFS and 0.22 by IIHS, respectively (both P<0.01). The intensity scores of HBsAg in patients with serum positive HB-sAg, HbeAg and positive HBV- DNA were significantly higher than those with positive HBsAg, HBeAb, HBcAb and negative HBV- DNA(P<0.05 or 0.01). Conclusion The improved immunohistochemical staining method can increase the detection rate of renal HBAg in HBV- GN patients;and the intensity score of HBsAg is predictable for the severity of HBV infection.
