Clinicopathological Features And Prognostic Analysis Of Primary Membranous Nephropathy Complicated With HBV Infection

Objective:To retrospectively analyze the clinicopathological characteri stics of adult primary membranous nephropathy with hepatitis B virus(H BV)infection and adult primary membranous nephropathy without HBV i nfection,and compare the difference of prognosis between the two groups,so as to provide theoretical basis for the treatment of patients with prim ary membranous nephropathy with HBV infection.Methods:patients who were diagnosed with PMN who were hospital ized in the first affiliated Hospital of Guangxi Medical University from 2014 to 2020 were collected,who were diagnosed by renal biopsy and exc luded secondary factors and were followed up for more than 6 months.A ccording to the presence of HBV infection,the patients were divided into two groups:PMN-HBV group and PMN group.The clinical data,laborat ory examination results and renal pathological results of the two groups w ere collected and analyzed,and the prognosis of the two groups were co mpared.Results:(1)A total of 117 patients were included,including 59 in the PMN-HBV group and 58 in the PMN group.There was no significant difference in gender composition between the two groups.There were differences in age composition between the two groups,PMN-HBV group was younger than PMN group(p<0.05).The number of hypertension cases in PMN combination was significantly higher than that in PMN-HBV group(p<0.05).There was no significant difference in smoking rates between the two groups.(2)The levels of AST and ALT in PMN-HBV group were higher than those in PMN group(p<0.05),and the levels of serum complement C3 and C4 were lower than those in PMN group(p<0.05),and the difference was statistically significant.Two groups of patients in the urine protein,white blood cell count,red blood cell count,hemoglobin,platelet count,neutrophil count,lymphocyte count,total protein,albumin,total bilirubin,direct bilirubin,urea,creatinine,uric acid,the elf inhibition C,cholesterol,triglyceride,immunoglobulin Ig G,immunoglobulin Ig A,immunoglobulin Ig M,CD4~+T and CD8~+T,the respect such as e GFR,urinary occult blood,PLA2R antibodies differences had no statistical significance(p>0.05).(3)The intensity of Ig G deposition in the PMN-HBV group was higher than that in the PMN group,and the difference was statistically significant(p<0.05).There were no significant differences in pathological stage composition,glomerular sclerosis,capillary wall thickening,renal tubule atrophy,interstitial fibrosis,and C3 deposition between the two groups(p>0.05).(4)The remission rate of PMN group was higher than PMN-HBV group after treatment,and the difference was statistically significant(p<0.05).Conclusion:(1)The age of onset of primary membranous nephropathy with HBV infection was lower than that of primary membranous nephropa thy.(2)High level of transaminase and low level of complement were com mon in primary membranous nephropathy patients with HBV infection;Th e deposition of Ig G in kidney tissue was strong.(3)The clinical effect of p rimary membranous nephropathy with HBV infection may be worse than t hat of primary membranous nephropathy.