利妥昔单抗治疗儿童原发性肾病综合征研究进展  

Study Progress of Rituximab Therapy on Primary Nephrotic Syndrome in Children

作　　者：孟磊[1,2] 任榕娜[1,2] 余自华[1,2] 

机构地区：[1]福建医科大学福州总医院临床医学院儿科,福州350025 [2]南京军区福州总医院儿科,福州350025

出　　处：《实用儿科临床杂志》2011年第5期375-378,共4页Journal of Applied Clinical Pediatrics

基　　金：福建省自然科学基金(2006J0119);南京军区医学科学技术研究"十一.五"计划课题(06MA148;06MA151);南京军区医学科技创新课题(08MA102)

摘　　要：原发性肾病综合征(PNS)是儿童时期常见的肾小球疾病,约25%的频复发型肾病综合征(FRNS)或激素依赖型肾病综合征(SDNS)患儿在成年期仍需用激素和(或)免疫抑制剂(ISA)维持治疗;约35%的激素耐药型肾病综合征(SRNS)患儿加用免疫抑制剂仍不缓解。利妥昔单抗是一种人鼠嵌合型抗CD20单克隆抗体,作为PNS的三线药物用于治疗对ISA如环磷酰胺、环孢素、他克莫司、霉酚酸酯等反应不佳、且不良反应严重的FRNS/SDNS和SRNS患儿,已取得较好的近期疗效,其远期疗效及安全性尚需多中心、前瞻性、大样本的随机对照试验证实。Primary nephrotic syndrome（PNS） is the common glomerular disease during childhood,about 25% of children with frequently relapsing nephrotic syndrome（FRNS） or steroid-dependent nephrotic syndrome（SDNS） still need prolonged treatment with steroids/immunosuppressive agents（ISA） in adulthood,and about 35% of children with steroid-resistant nephrotic syndrome（SRNS） treated with additio-nal ISA have achieved no remission.Rituximab,a chimeric human/mouse monoclonal anti-CD_20 antibody,is a third-line drug for treating PNS,and has made a good short-term effect in the treatment of FRNS/SDNS or SRNS in children who showed poor response to ISA such as cyclophosphamide,ciclosporin,tacrolimus mycophenolate mofetil,and so on,or in whom ISA developed severe drug toxicity.Multi-center,prospective,large samples and randomized controlled trials are still required to prove long-term effect and safety of rituximab in childen with PNS.

关 键 词：肾病综合征 利妥昔单抗 儿童 

分 类 号：R726.9[医药卫生—儿科]