乙肝并发肾病患者肝肾功能及血脂和补体指标的相关性研究

摘要

Objective To explore serum liver and kidney function,blood lipid,complement indicators in patients with hepatitis B-associated nephropathy and the relationship between HBV infection and kidney function.Methods 141 cases with hepatitis B-associated nephropathy were randomly selected from January 2015 to July 2016 from Renmin Hospital of Wuhan University including 96 male,female 45 eases.65 cases with nephropathy included 31 male,female 34 eases.68 cases with healthy people included 36 male and female 32 cases.Liver and kidney function parameters were detected by the automatic biochemical analyzer Siemens ADVIA 2400.Complement C3 and C4 were detected by the automated immunoassay analyzer Beckman 1MMAGE 800.HBV DNA load was detected by fluorescence quantitative PCR instrument ROCHE LightCycler(R)480.Results ALT,Cr,UA,Urea,β2-M,LDL,TCh,TG,C3 and C4 were significant difference among hepatitis B complicated with nephropathy,nephropathy group and healthy groups (FALT =6.50,FCr=46.02,FUA =32.89,FUrea =37.60,Fβ2 M =44.98,FLDL=4.13,FTch =5.20,FTG =26.90,FC3 =14.54,Fc4 =11.01,all P＜0.05).ALT,AST,β2-M,C3 and C4 were significant difference among hepatitis B activity period complicated with nephropathy,hepatitis B non-activity period complicated with nephropathy and nephropathy group (FALT =5.96,FAST =7.45,Fβ2-M =18.70,FC3 =5.32,Fc4 =4.16;all P＜0.05).Conclusion Concentrations of liver and kidney function,blood lipid abnormalities and complement had a certain relationship with the hepatitis B complicated with nephropathy and HBV had a certain effect on serum concentrations of β2-M and complement.%目的 探讨乙肝并发肾病患者血清肝肾功能、血脂、补体指标的变化以及HBV感染与肾脏功能的关系.方法 选择2015年1月～2016年7月武汉大学人民医院肾病内科住院的乙肝并发肾病患者141例,其中男性96例,女性45例.单纯肾病患者65例,其中男性31例,女性34例.健康对照人群共68例,其中男性36例,女性32例.肝肾功能和血脂指标由Siemens ADVIA 2400全自动生化仪测定,补体C3和C4由Beckman IMMAGE800全自动免疫分析仪测定.HBVDNA载量由Roche LightCycler(R) 480荧光定量PCR仪测定.结果 肝肾指标ALT,Cr,UA,Urea和β2-M,血脂指标LDL,TCh和TG,补体C3和C4在乙肝并发肾病组,单纯肾病组和健康对照组间比较,差异具有统计学意义(FALT=6.50,FCr=46.02,FUA=32.89,FUrea=37.60,Fβ2-M=44.98,FLDL=4.13,FTCh=5.20,FTG=26.90,FC3=14.54,FC4 =11.01;均P＜0.05).肝肾功能指标ALT,AST和β2-M,补体C3和C4在乙肝活动期并发肾病,非乙肝活动期并发肾病和单纯肾病组间比较,差异均具有统计学意义(FALT=5.96,FAST=7.45,Fβ2-M=18.70,FC3=5.32,FC4 =4.16;均P＜0.05).结论 肝肾功能、血脂和补体浓度异常与乙肝并发肾病具有一定的关系,并且HBV感染影响肾病患者血清β2-M和补体浓度.