【摘要】 目的　探讨肾组织中乙型肝炎病毒 (HBV)DNA和RNA的存在及其致病作用。方法　通过原位杂交检测 2 7例HBV相关肾炎患者肾组织中HBVDNA和RNA的存在和分布情况 ,探讨HBV在肾组织中的致病机理。结果　患者肾组织中存在HBVDNA和RNA ,其分布与HBV抗原基本一致 ,主要存在于肾小管上皮细胞胞浆和细胞核内 ,以及肾小球系膜区 ,毛细血管袢等处 ;肾小管上皮细胞内HBVDNA和RNA阳性率分别为 81.5 %、6 3.0 % ,显著高于肾小球内的 48.1%、2 5 .9% (P <0 .0 5 )。结论　HBV在肾组织 ,特别是在肾小管上皮细胞中存在并复制。复制时表达的抗原 ,与来自循环的抗原相似 ,都可能导致免疫复合物形成或细胞免疫而损伤肾脏致病。肾小管间质病变与小球病变同样决定HBV相关肾炎病情的进展和预后更多还原

【Abstract】 Objective To study the presence and pathogenesis of hepatitis B virus (HBV) DNA and RNA in renal tissues. Methods The presence and distribution of HBV DNA and RNA were investigated in renal biopsy tissues of 27 patients with HBV associated glomerulonephritis by in situ hybridization assay to explore the pathogenesis of HBV in renal tissue. Results HBV DNA and RNA, the same as HBV antigens, were present in renal tissues and located in the nuclei and cytoplasm of renal tubular epithelial cells, glomerular mesangium and capillary loops. HBV DNA and RNA were detected in tubular epithelia with the positive rates of 81.5%,63.0% respectively, which were significantly higher than those in glomeruli (48.1%, 25.9% respectively) ( P <0.05). Conclusion That HBV exists and replicates too in renal tissues,predominantly in tubular epithelia. The HBV antigens expressed in situ, as well as the antigens from circulation, and lead to renal lesions through immune complex formation or cell immune involvement. Besides glomerular lesions, tubulointerstitial lesions might also determine the progression and prognosis of HBV associated glomerulonephritis.更多还原