CAJ | 학술논문

目的探讨血清学标志物阴性的乙肝病毒相关性肾炎的临床与病理特点,提高对乙肝病毒相关性肾炎的认识,从而避免误诊与漏诊.方法回顾性分析33例乙肝血清学标志物阴性、经活检诊断为乙肝病毒相关性肾炎患者的临床与病理资料.结果 33例血清学标志物阴性的患者中,29例临床表现为肾病综合征,4例表现为肾炎综合征;病理类型:经典膜性肾病6例,不典型膜性肾病27例.结论 ①乙肝血清学标志物并非确诊乙型肝炎病毒相关性肾炎(HBV-GN)的必要条件,血清抗原阴性不能排除HBV-GN的诊断,尤其是肾脏病理类型为不典型膜性肾病的青少年患者;②血清学标志物阴性的乙肝病毒相关性肾炎患者临床表现以肾病综合征为主,病理类型以不典型膜性肾病为最多.
목적 탐토혈청학표지물음성적을간병독상관성신염적림상여병리특점,제고대을간병독상관성신염적인식,종이피면오진여루진.방법 회고성분석33례을간혈청학표지물음성、경활검진단위을간병독상관성신염환자적림상여병리자료.결과 33례혈청학표지물음성적환자중,29례림상표현위신병종합정,4례표현위신염종합정;병리류형:경전막성신병6례,불전형막성신병27례.결론 ①을간혈청학표지물병비학진을형간염병독상관성신염(HBV-GN)적필요조건,혈청항원음성불능배제HBV-GN적진단,우기시신장병리류형위불전형막성신병적청소년환자;②혈청학표지물음성적을간병독상관성신염환자림상표현이신병종합정위주,병리류형이불전형막성신병위최다.
Objective To investigate the clinical and pathological features of patients with hepatitis B virus associated glomerulonephritis (HBV-GN) whose serum markers of HBV were negative,and to improve the recognition of HBV-GN,so as to avoid the misdiagnosis and missed diagnosis.Methods The data of 33 patients with HBV-GN confirmed by renal biopsy,with and negative serum markers of HBV were collected,and the clinical and pathological features were analyzed retrospectively.Results Among the 33 cases with negative serum markers of HBV,29 patients with presented nephrotic syndrome,4 patients with nephritic syndrome.Pathological types:6 cases with manifested classic membranous nephropathy and 27 cases with atypical membranous nephropathy.Conclusions ①HBV serum markers are unnecessary conditions for diagnosing HBV-GN,patients with negative serum antigen of HBV cannot be excluded with the diagnosis of HBV-GN,especially for adolescent patients with atypical membranous nephropathy.②Nephrotic syndrome is the maon clinical manifestation and atypical membranous nephropathy is the most frequent pathological type in patients with HBV-GN whose serum makers of HBV are negative.