CLINICAL AND PATHOLOGICAL ANALYSIS ON HBV-ASSOCIATED GLOMERULONEPHRITIS

[Objective]To investigate the clinical and pathological features of hepatitis B virus associated glomerulonephritis,and the relationship between hepatitis Virus B Marker expression and renal pathology.[Methods]From 2004 to 2010,51 HBV-GN patients were confirmed by renal biopsy.Their clinic and pathological data were analyzed by statistic methods.[Results]Among 51 patients with HBV-GN,21(20.19%)were ipusnephretis accompanied with HBV-GN.50% were membranous nephropathy and 23.33% were proliferative glomerulonephritis in 31 patients with HBV-GN.Diffuse proliferative glomerulonephriti and membranous nephropathy were the dominant type in 21 patients with ipusnephretis accompanied with HBV-GN.Full house phenomenon was found in 39 patients by immunopathology(76.47%).45 cases showed positive κ chain in nephridial tissue(88.24%).42 cases showed positive λ chain(82.35%).HBsAg positive in 18 patients(35.29%).Glucocorticoid was used in combination with mycophenolate mofetil and ACEI in the treatment of ipusnephretis,and the total effective rate was 95.23%.For patients with HBA-DNA positive,Lamivudine was used.The total effective rate was 83.33% and 93.33% in HBA-DNA positive and negative group.[Conclusion]Patients with HBV-GN was associated with various of renal pathological changes,with IgA and MN being the dominant types.The diagnosis of HBV-GN cannot be excluded in HBsAg negative patients.Immunohistochemical makers of HBV antigen was commonly observed ipusnephretis.Combination with?mycophenolate mofetil and ACEI were effective in the treatment of HBV-GN.