摘要
目的比较乙肝相关性膜性肾病(HBV-MN)和乙肝相关性膜增生性肾小球肾炎(HBV-MPGN)的病理特征及病毒抗原沉积特点。方法选择2016年1月至2018年12月送广州金域医学检验中心肾脏病理中心会诊的乙肝病毒相关性肾病患者80例作为研究对象,根据病理诊断,将40例HBV-MN患者纳入MN组,其余40例HBV-MPGN患者纳入MPGN组。比较两组患者肾脏标本的病理特征及免疫球蛋白(IgM、IgA和IgG)、补体(C3和C1q)水平在肾脏中的沉积情况,以及HBcAg和HBsAg在肾脏组织中的沉积特点。结果两组标本中系膜增生比例差异无统计学意义(P>0.05);但MN组中伴有局灶硬化、基底膜增厚及钉突的比例明显高于MPGN组,差异均有统计学意义(P<0.05)。两组标本IgM、IgA和C3沉积比例差异无统计学意义(P>0.05);但MN组样本中发现IgG和C1q比例明显高于MPGN组,差异有统计学意义(P<0.05)。MN组有21例患者标本检出HBcAg沉积,而MPGN组所有标本均检出HBcAg沉积,MPGN组HBcAg沉积检测率明显高于MN组,差异有统计学意义(P<0.05);MN组HBsAg沉积检出率为82.50%,明显高于MPGN组的60.00%,两组HBsAg沉积检出率差异有统计学意义(P<0.05);此外,MN组检出的乙肝抗原多分布于毛细血管襻,而MPGN组的乙肝抗原多分布于系膜区,部分毛细血管襻可见颗粒状节段分布。结论HBV-MN和HBV-MPGN具有极为不同的病理特征,且乙肝病毒抗原的沉积情况也有明显差异,二者发病机制存在很大差异。
Objective To compare the pathological and virus antigen deposition characteristics between Hepatitis B related Membranous Nephropathy (HBV-MN) and Hepatitis B associated membrane proliferative glomerulonephritis (HBV-MPGN). Methods A total of 80 patients with hepatitis Bvirus-associated nephritis who were sent to the Kidney Pathology Center of Guangzhou Jinyu Medical Testing Center from January 2016 to December 2018 were enrolled in the study.According to pathological diagnosis,40 patients with HBV-MN were included in the MN group,and the remaining 40 patients were included in the MPGN group.The pathological features of kidney specimens,the deposition of immunoglobulins (IgM,IgA and IgG),complement (C3 and C1q) in the kidney,and the deposition of HBcAg and HBsAg in renal tissues were compared between the two groups. Results There was no significant difference in the proportion of mesangial hyperplasia between the two groups( P >0.05).The proportion of segmental sclerosis,thickened basement membrane and the presence of rete pegs in MN group were significantly higher than those in MPGN group,the differences were statistically significant( P <0.05).There was no significant difference in the proportion of IgM,IgG and C3 deposition between the two groups( P >0.05).But,the proportion of IgG and C1q deposition in MN group was much higher than that in MPGN group,the differences were statistically significant( P <0.05).HBcAg deposition was found in 21 of 40 samples in MN group but was found in all samples in MPGN group.The detection rate of HBcAg deposition in MN group was significantly lower than that in MPGN group,the differences were statistically significant( P <0.05).The detection rate of HBsAg deposition in MN group was 82.50%,which was much higher than 60.00% in MPGN group,the differences were statistically significant( P <0.05).Besides,the majority of HBV antigen was deposited in capillary loops in MN group,but it was mainly observed in mesangial region and granular segment was visible in some capillary loops in M
作者
高志芳
范肖芳
侯晓涛
岳书玲
刘金莲
GAO ZHifang;FAN Xiaofang;HOU Xiaotao;YUE Shuling;LIU Jinlian(Department of Clinical Laboratory,Guangning County Hospital of Traditional ChineseMedicine,Zhaoqing,Guangdong 526300,China;Guangzhou Jinyu Medical InspectionCenter,Guangzhou,Guangdong 510005,China)
出处
《检验医学与临床》
CAS
2019年第13期1876-1879,共4页
Laboratory Medicine and Clinic
关键词
乙肝病毒相关性肾病
乙肝相关性膜性肾病
乙肝相关性膜增生性肾小球肾炎
抗原沉积
hepatitis B virus associated glomerulonephritis
hepatitis B related membranous nephropathy
hepatitis B associated membrane proliferative glomerulonephritis
antigen deposition
