C3肾小球病治疗进展  

Advances in the treatment of C3 glomerulopathy

作　　者：陈楠[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院肾脏科上海交通大学医学院附属肾脏病研究所,上海200025

出　　处：《中国实用内科杂志》2017年第9期790-793,共4页Chinese Journal of Practical Internal Medicine

摘　　要：C3肾小球病包括C3肾小球肾炎和致密物沉积病,临床表现多样,诊断依赖于肾活检。目前尚无统一的治疗标准,建议针对病因治疗,控制补体旁路途径过度激活。肾病综合征伴或不伴肾功能不全患者建议积极治疗,治疗方案包括激素联合免疫抑制剂;生物制剂:抗CD20单抗——Rituximab少部分患者有效,抗C5单抗-Eculizumab(中国未上市)多数疗效佳;血浆置换和(或)冰冻血浆输注有一定疗效;可肾移植治疗,但复发率高。C3 glomerulonephropathyincludes C3 glomerulonephritis and dense deposit disease, which has a variety of clinical manifestations and its diagnosis depends on renal biopsy. There is no uniform treatment guideline, and it is recommended treatment should be according to the etiology of C3 glomerulonephropathy, by controlling the overactivation of the complement alternative pathway. Nephrotic syndrome with/without renal insufficiency inpatients is recommended to be managed by active treatment, and. Treatment options include steroids combined with immunosuppressive agents; biological agents anti-CD20 monoclonal antibody- Rituximab is effective in a small number of patients; howerver, anti-C5 monoclonal antibody-Eculizumab which is not listed in China, is effective in most patients; plasma exchange/frozen plasma infusion has a certain effect; kidney transplant is advisible, but the recurrence rate is high.

关 键 词：C3肾小球病 补体旁路途径 ECULIZUMAB 

分 类 号：R692.3[医药卫生—泌尿科学]