【摘要】 目的探讨乙型肝炎病毒(HBV)mRNA原位杂交检查在乙型肝炎病毒相关性肾炎(HBV-GN)诊断中的应用价值以及HBV感染在HBV-GN发生中的作用。方法利用原位杂交方法对40例HBV-GN肾组织的石蜡标本进行HBV mRNA检测,并用统计学方法分析HBV mRNA的表达与HBV-GN患者性别、年龄、血肌酐、24小时尿蛋白定量、血清中HBV-DNA载量等临床特征的关系。结果HBV mRNA主要位于肾小管上皮细胞胞质内,部分肾小球上皮、内皮、系膜细胞胞质内也有分布,其阳性率分别为95%(38/40)和20%(8/40),肾小管表达阳性率显著高于肾小球(P<0.01)。HBV mRNA表达在HBV-GN患者性别、年龄、血肌酐等临床特征中无明显差异(P>0.05);在患者24小时尿蛋白定量中差异极显著(P<0.01);与患者血清中HBV-DNA载量间差异显著(P<0.05)。结论HBV-GN肾组织(尤其是肾小管上皮细胞)中存在HBV mRNA,提示HBV可能通过在肾小管上皮细胞内转录、复制,导致肾损害,引发或加重蛋白尿。利用HBV mRNA原位杂交检测可以准确地诊断HBV-GN。更多还原

【Abstract】 Objective To detect the expression of hepatitis B virus(HBV) mRNA in renal tissues of hepatitis B virus associated nephritis(HBV-GN),to analyze the clinical features of patients,and to discuss the application of HBV mRNA detection by in situ hybridization in HBV-GN diagnosis and relationship between HBV infection and HBV-GN pathogenesis.Methods The expression of HBV mRNA was detected in 40 cases of HBV-GN renal tissues by in situ hybridization.The relationship between HBV mRNA expression and the patients’ clinical features,such as sex,age,creatinine,quantitative examination of 24 hours urinary protein and HBV-DNA serological examination,was analysed by statistical methods.Results HBV mRNA mainly located in the cytoplasm of renal tubular epithelial cells,and partially in cytoplasm of glomerular epithelial,endothelial and mesangial cells.Their positive rates were 95%(38/40) and 20%(8/40) respectively.The expression of HBV mRNA in renal tubule was significantly higher than that in glomeruli(P<0.01).There was no difference between HBV mRNA expression and sex,age,creatinine of patients(P>0.05).There was significantly difference between HBV mRNA expression and quantitative examination of 24 hours urinary protein(P<0.01).There was also difference between HBV mRNA expression and HBV-DNA copy in serological examination(P<0.05).Conclusion The expression of HBV mRNA in HBV-GN renal tissues(especially tubular epithelial cells) suggests that HBV might transcript and replicate in tubular epithelial cells,which might lead to the renal injury,cause or increase proteinuria.HBV-GN can be accurately detected by in situ hybridization.更多还原