【摘要】 目的通过研究EB病毒(EBV)、人巨细胞病毒(HCMV)在膜性肾病患者肾组织中的表达情况,探讨EBV、HCMV感染与膜性肾病的发生、发展的关系。方法回顾分析2011年1月至2012年12月山西医科大学第二医院经肾脏穿刺活检术后由电镜确诊为膜性肾病,并排除已经确诊为狼疮性膜性肾病及乙型肝炎病毒相关性膜性肾病的共84例患者的完整临床及病理资料,并进一步将其分为特发性膜性肾病组(IMN,40例)、不典型膜性肾病组(AMN,44例)。比较两组的临床特点,并利用核酸原位杂交技术检测两组患者肾组织内EBV及HCMV的感染情况。采用SPSS 16.0统计软件进行统计学分析。结果与IMN相比,AMN的发病年龄更小(31.42±14.5与51.08±6.74,t=1.637,P<0.05),镜下血尿发生比例更高(72.2%与45.8%,χ~2=6.686,P<0.05),肾组织Clq(79.54%与25.0%,χ~2=25.063,P﹤0.001)、Ig A(59.1%与35.0%,χ~2=4.875,P<0.05)及Ig M(79.54%与47.5%,χ~2=9.372,P<0.05)沉积明显增多;AMN和IMN肾组织中EB病毒阳性率差异无统计学意义(36%与25%,χ~2=1.266,P>0.05);肾组织中HCMV在膜性肾病中有较高的阳性率,且不典型膜性肾病阳性率更高(90%与63%,χ~2=9.661,P<0.05)。结论肾组织HCMV和EBV感染可能参与膜性肾病的发生。更多还原

【Abstract】 Objective To investigate the relationship between Epstein-Barr virus(EBV),human cytomegalovirus(HCMV)infections and the occurrence and development of membranous nephropathy(MN)by studying the expression of EBV and HCMV in renal tissues of patients with MN.Methods 84 patients diagnosed as MN by renal biopsies from January 2011 to December 2012 were included.Nucleic acid in-situ hybridization technology was used to detect EBV and HCMV in kidney tissues.SPSS 16.0 statistical software was applied for analysis.ResultsCompared with idiopathic MN(IMN),patients with atypical MN(AMN)were younger(31.42±14.5 vs 51.08±6.74,t=1.637,P<0.05),had higher proportion of microscopic haematuria(72.2%vs 45.8%,χ~2=6.686,P<0.05),and more renal deposits of C1q(79.54%vs 25.0%,χ~2=25.063,P﹤0.001),IgA(59.1%vs 35.0%,χ~2=4.875,P<0.05)and IgM(79.54%vs 47.5%,χ~2=9.372,P<0.05).The patients with IMN and AMN had no statistical differences in expression of EBV in renal tissue(36%vs 25%,χ~2=1.266,P>0.05);The expression of HCMV in the kidney tissues of MN was high,and higher in AMN(90%vs 63%,χ~2=9.661,P<0.05)than in IMN patients.Conclusion The infections of EBV and HCMV in renal tissues may be involved in the pathogenesis of MN.更多还原