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本文报告乙型肝炎相关抗原性肾炎16例,年龄3.5～12岁。2例表现为肾炎,14例表现为肾病综合征。11例肝脏有轻及中度肿大。4例 SGPT 升高,血清 HBsAg 多次阳性,滴度1:256～1:12,800,9例同时有 HBcAb 或 HBeAg 阳性。10例作了肾穿刺活检,病理改变6例为膜型肾炎,3例为系膜增殖型肾炎,1例为内皮系膜增殖型肾炎。4例肾组织免疫荧光检查示 IgG和 C_3沉积,1例抗 HBsAg 染色阳性。电镜检查肾小球毛细血管壁基底膜外侧、系膜区或内皮细胞下有电子致密沉积,2例肝穿刺活检示肝炎病变。经治疗后,2例表现为肾炎者随访10～15月尿常规已基本恢复;14例表现为肾病综合征者8例获近期缓解,但尿蛋白转阴缓慢,4例进步,2例无效。
This article reports 16 cases of hepatitis B-associated antigenic nephritis, aged 3.5 to 12 years. 2 cases showed nephritis, 14 cases showed nephrotic syndrome. Eleven patients had mild and moderate liver enlargement. 4 cases of SGPT increased, serum HBsAg multiple positive, titer of 1: 256 ~ 1: 12,800,99 cases of both HBcAb or HBeAg positive. Ten patients underwent renal biopsy, pathological changes in 6 cases of membranous nephritis, 3 cases of mesangial proliferative nephritis, 1 case of endothelial mesangial proliferative nephritis. Four cases of renal tissue immunofluorescence showed IgG and C_3 deposition, 1 case of anti-HBsAg staining positive. Electron microscopy of glomerular capillary wall basement membrane outside the mesangial area or endothelial cells dense electron deposition, liver biopsy showed liver lesions in 2 cases. After treatment, 2 cases of nephritis were followed up 10 to 15 months urine routine recovery; 14 cases showed nephrotic syndrome in 8 cases were recently alleviated, but urine protein slow down, 4 cases of improvement, 2 cases of ineffective.