中文摘要：

目的研究B细胞在狼疮肾炎患者肾组织的浸润情况，探讨B细胞浸润与狼疮肾炎肾组织病理改变的关系及临床意义。方法收集119例处于活动期的狼疮肾炎患者肾组织标本。应用免疫酶组织化学方法检测肾组织中B细胞的浸润情况，根据浸润程度分为5级。统计分析采用两独立样本t检验和，检验。结果①119例狼疮肾炎中有B细胞浸润62例（52．1％），B细胞主要浸润于肾间质组织，多见于Ⅳ型狼疮肾炎患者，V型少见。②狼疮肾炎肾组织中B细胞浸润同无浸润组比较肾组织活动指数及慢性指数显著升高。差异有统计学意义；B细胞浸润组同无浸润组的血尿素氮水平比较[（12±9）与（6±3）mmol／L]、血清肌酐水平[（105±84）和（61±21）μmol／L]（P〈0．01）。③狼疮肾炎肾组织中以IgG型抗体荧光强度最强；B细胞浸润组与无B细胞浸润组问各亚型抗体沉积率比较差异无统计学意义（P均〉0．05）。结论狼疮肾炎中伴有肾组织B细胞浸润的患者病变重于无B细胞浸润者，局部B细胞可能以非抗体生成细胞的方式参与狼疮肾炎病变。

英文摘要：

Objective To investigate B-cell distribution in lupus nephritis and evaluate its significance in pathological classification. Methods Kidney biopsy specimens were obtained consecutively from 119 patients with LN, B lymphocytes distribution were detected using immunohistochemical staining with specific antibodies and were classified into 5 groups. Chi-square test and t test were used for statistical analysis. Results ① B lymphocytes infiltration occurred in 52.1% of the LN patients （62/119）, B lymphocytes were mainly distributed in the renal interstitial tissue, which occurred most frequently in class IV LN but rare in class V LN. ② B-cell infiltrating group was associated with active disease presentations and chronic indices P〈0.01 ）. Blood urea nitrogen（BUN） [（12±9） vs （6±3） mmol/L] and serum creatinine（Cr） [（105±84） vs （61±21）μmol/Ll were higher in B-cell infiltrates group than non-B-cell infihration group （all P〈0.01 ）. ③ Kidney biopsy specimens showed predominantly IgG deposit in immune-fluorescency intensity examination. The Ig subtype which deposited in B-cell infiltrating group was not statistically different from those deposited in uon-B cell infiltrating group （P〉0.05）. Conclusion This study has shown that renal B cell infiltration occurs in 52. 1% of the LN patients. Patients with renal B cell infiltration have more severe kidney tissue injury and poorer renal outcomes than patients without B cell infiltration. Renal B lymphocytes infiltration may contribute to the pathogenesis of LN in a non-antibody-secreting way.