乙型肝炎病毒相关性肾炎的关联因素分析-论文.pdf

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1、3月第39鲞筮23期JiangsuMedJ，December2013，Vo139，No．23●论著乙型肝炎病毒相关性肾炎的关联因素分析张承宁葛益飞孙彬赵秀芳钱军邢昌赢【摘要】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

2、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．4O．、54和2、3O．O0vs．9．46)(P

3、04AnanalysisoffactorsrelatedtohepatitisBvirus-associatedglomerulonephritisZHANGChengning，GEYifei，SUNBin，eta1．DepartmentofNephrology，FirstAffiliatedHospital，NanjingMedicalUniversity，Nanjing210029，CHINA[Abstract]ObjectiveToanalyzeofthefactorsrelatedtohepatitisBvirus(HBV)一associatedg

4、lomerulonephrms(GN)inthepatientswithchronichepatitisBvirus．MethodsOnthebasisofkidneybiopsy，144patientswithchronichepatitisBvirusweredividedinto2groupsofHBV—GN(withHBV—GN，70cases)andnon-HB、GN(withnon-HBv_GN，74cases)．ClinicopathologicalparameterswerecomparedbetweentWOgroups．ResultsC

5、linicalmanifestationsshowedthatgroupHBGNgaveprioritytowithnephroticsyndrome(47．14)，butgroupnon_HBv_GNgaveprioritytowithhematuriaand(or)proteinuria(55．41)．PathologicaltypesshowedthatgroupHBV—GNgaveprioritytowithmembranousnephropathy(41．43)，butgroupn0n_HBV—GNgaveprioritytowithIgAnep

6、hropathy(39．19)．ThereplicationrateofhepatitisBviruswashi【gheringroupHBV—GNthanthatinn0n_HBv-GNgroup(6O．OOVS．4O．54)(P<0．05)．HB~AgpositiverateofgroupHBV—GNwashigherthanthatofgroupnon-HB、LGN(3O．O0VS．9．46)(P

7、ururinaryproteinbetweentwogroups．ConclusionTheindicatorsofmale，hepatitisBvirusreplication，HBe船positive，elevatedALT。decreasedserumIgG，severeproteinuriaindicateahigherpossibilitythatHBVaccountsforthekidneydamageinthepatientswithchronichepatitisBvirus．[Keywords]HepatitisBvirus-associ

8、atedglomerulonephritis[JiangsuMed