Clinicopathotogical Analysis Of Hepatitis B Virus Associated Glomerulonephritis

Objective:The purpose of this study is to analyze the clinical featuresand pathological data of hepatitis B virus associated glomerulonephritis(HBV-GN), further explore its related factors and possible pathogenesis of this disease.Methods:We performed a retrospective analysis of21cases patientsaccepted renal biopsy and detected HBsAg and (or) of HBcAg in renaltissue diagonosed in the First Hospital of Jilin University fromJanuary2013to January2015(hereinafter referred to as HBV-GNgroup).At the same time, we collected23cases nephritis patientsunderwent renal biopsy examination of serum HBV markers positive butin renal tissue without HBsAg and (or) HBcAg deposited as controlgroup(hereinafter referred to as HBV-PG group).Analysis of theclinical data and pathological features of the2groups of patients.Statistical analysis was performed using SPSS17.0software.Results:Two groups compared,age,gender,clinical manifestation,white blood cell,red blood cell,hemoglobin,platelet,activated partial prothrombin time,prothrombin time,international normalized ratio,prothrombin activity,fibrinogen,aspartate aminotransferase,alanine aminotransferase,γ-glutamyl transpeptadase,alkaline phosphatase,choli nesterase,total protein,albumin,total bilirubin,direct bilirubin,urea nitrogen,serum creatinine,triglycerideglucose,high-density lipoprotein cholesterol,Immunoglobulin A,Immunoglobulin M,Immunoglobulin G,Complement3,24-hour urine protein quantity with similar results, there were no significant statistical difference between HBV-GN group and HBV-PG group(p>0.05).But there were significant statistical difference between HBV-GN group and HBV-PG group in totalcholesterol,Low-density lipoprotein cholesterol,Complement4.In terms of serum HBV markers,HBV-GN group in patients with hepatitisB serological marker reminder that "big3this world"(HBsAg, HBeAg and HBcAb were positive)in12cases (52.4%),"small3this world"(HBsAg, HBeAb and HBcAb were positive) in7cases (19.0%). HBV-PG groups of patients with hepatitis B serological marker reminderthat "big3this world"(HBsAg, HBeAg and HBcAb were positive)in5cases (30.4%),"small3this world"(HBsAg, HBeAb and HBcAb werepositive) in17cases (60.9%).Two groups of patients with hepatitis B serological markers were statistically significant.Two groupsof patients in the quantitative analysis of hepatitis B virus, HBV-GN group in patients with hepatitis B virus DNA by quantitativeHBV-DNA＜103IU/ml in3cases(14.3%),103＜HBV-DNA＜105IU/ml in7cases(33.3%), HBV-DNA＞105IU/mL11cases(52.4%). HBV-PG group in patients with HBV-DNA＜103IU/ml in9cases(39.1%),103＜HBV-DNA＜105IU/ml in10cases(43.5%), HBV-DNA＞105IU/ml in4cases(17.4%). Therewere statistically significant differences in the distribution oftwo groups of patients with hepatitis B virus quantitative.In the renal pathological types,21cases of HBV-GN patients,18cases of membranous nephropathy (85.7%), mesangial proliferative glomerulonephritis1cases (4.8%) and focal proliferative IgA nephropathyin2cases (9.5%).23cases of HBV-PG patients with membranous nephropathy in9cases (39.1%),3cases of membranoproliferative glomerulonephritis (13.0%),11cases of focal proliferative IgA nephropathy (47.8%). There were significant differences between the twogroups of patients with renal pathological type distribution.In th-e kidney pathology immunofluorescence,21cases of HBV-GN patients，immunofluorescence deposition distribution of IgA in13patients (61.9%), IgM in13patients (61.9%), IgG in19cases (90.5%), C3in19cases (90.5%), C4in14cases (66.7%), C1q in14cases (66.7%) and F fragment in10cases (47.6%). In23cases with HBV-PG，immunofluorescence deposition was IgA in18cases (78.3%)，IgM in82.6cases (82.6%)，IgG in14cases (60.9%), C3in13cases (56.5%),C4in6cases(26.1%)，C1q in11cases (47.8%) and F fragment in9cases (39.1%). Thus, HBV-GN group in renal tissue of IgG, C3and C4deposition positive rate was significantly higher than that of HBV-PG group, the difference between the two groups was statistically significant (P＜0.05) and that of IgA, IgM and C1q, F fragmentno different.Conclusion:1.There was no significant difference in clinical biochemicalparameters between the two groups of HBV-GN and HBV-PG,and the identification should be detected by biopsy and hepatitis B virusantigen detection.2.The quantitative level of HBV-DNA in patients with HBV-GN wassignificnattly higher than that of patients with HBV-PG,suggestingthat HBV highly duplicated were associated with the onset of HBV-GN.3. The deposition of C3, C4and IgG in renal tissues of HBV-GNpatients was significantly higher than that of patients withhepatitis B virus infection with primary glomerulopathy.