成人与小儿肾脏组织中HBV－DNA存在状态的比较

本文分析８例成人与７例小儿肾脏疾病的肾组织中检出的ＨＢＶ－ＤＮＡ。临床诊断：７例小儿均为乙肝病毒相关性肾炎（ＨＢＶ－ＧＮ）；８例成人中３例为ＨＢＶ－ＧＮ，其余为血尿待查、狼疮性肾炎和ＩｇＡ肾病。ＨＢＶ－ＤＮＡ在肾组织的存在状态在成人均为整合型，而小儿有整合型及游离型二种。小儿肾组织中ＨＢｓＡｇ阳性表达率高于成人。作者认为此现象可能与成人肾组织中ＨＢＶ－ＤＮＡ存在状态仅有一种整合型有关。另外发现肾组织中ＨＤｃＡｇ阳性率与ＨＢＶ－ＤＮＡ呈正相关。肾组织中ＨＢｃＡｇ阳性的患者局部有Ｔ细胞的浸润，提示了肾原性抗体存在及其在ＨＢＶ－ＧＮ中激发细胞免疫参与肾脏病变可能性。

Comparison of the state of HBV DNA in renal tis-sues from child and adult renal diseases

BV DNA has been identified in renal tissuesfrom 7 children and 8 adult patients with renal dis-eases. All 7 children were clinically diagnosed asHBV associated glomerulonephritis (HBV-GN). A-mong 8 adult cases, 3 were HBV-GN ,while the oth-ers included SLE nephritis, IgA nephropathy andisolated hematuria. In adult patients, HBV DNAwas present exclusively in an integrated form in re-nal tissues; while in children, HBV DNA was in anintegrated or/and in free episomal form.The rate ofdetectable HBsAg in renal tissue was higher in chil-dren than adult cases.This result might be attribut-ed to the difference in the status of HBV DNA inrenal tissues between children and adult. Further-more, the occurrence of HBcAg seemed to correlatewith the incidence of HBV DNA in renal tissue. Thefocal T cell infiltration on renal tissue was more fre-quently observed in HBcAg positive patients ,imply-ing that the HBV antigens derived from renal tis-sues as well as the relevant cellular immunologicalreaction might be involved in the pathogenesis ofHBV-GN.