利妥昔单抗治疗儿童原发性肾病综合征的临床研究进展  

Clinical trial progress of Rituximab therapy in children with primary nephrotic syndrome

作　　者：郝志宏 于力 Hao Zhihong;Yu li(Department of Pediatrics,Guangzhou First People′s Hospital,the Second Affiliated Hospital of South China University of Technology,Guangzhou 510180,China)

机构地区：[1]广州市第一人民医院,华南理工大学附属第二医院儿科,510180

出　　处：《中华实用儿科临床杂志》2020年第17期1303-1309,共7页Chinese Journal of Applied Clinical Pediatrics

基　　金：国家自然科学基金(81670652,81273205)。

摘　　要：原发性肾病综合征(PNS)是儿童常见的肾小球疾病,糖皮质激素单独或联合免疫抑制剂治疗是各种类型PNS的主要治疗方案,然而,约20%的PNS患儿在激素和/或免疫抑制剂治疗中或停药后仍表现为频复发或激素依赖,这部分患儿长期大量激素和/或免疫抑制剂治疗,不良反应大,甚至不能耐受,还有1%~3%的患儿对激素及所有免疫抑制剂治疗均无反应,这些患儿需要新的治疗方案。近15年来,利妥昔单抗(RTX)治疗各类型PNS的临床研究越来越多,结果显示RTX不仅可延长PNS缓解期、减少激素和免疫抑制剂量及不良反应,且有临床对照研究显示RTX可作为激素依赖或频复发型PNS的潜在的一线治疗药物及激素耐药型PNS的二线治疗药物。现对近年来RTX治疗儿童PNS的最新临床研究设计及结果作一总结,以期为RTX治疗PNS的临床实践及研究提供参考。Primary nephritic syndrome(PNS)is the most common glomerular disease in children.Glucocorticoid alone or concurrent with immunosuppressive agents is the main treatment for various types of PNS.However,about 20%of children with PNS still show frequent relapse or steroid dependence during or after withdrawal of hormones and/or immunosuppressive agents.For these children,the long-term and high-dose use of hormones and/or immunosuppressive agents cause serious side effects and even intolerance.Additionally,there are 1%-3%children with PNS showing no response to hormones and all immunosuppressive agents,and they need new treatment regiments.In recent 15 years,there have been increasing clinical trials on the treatment of various types of PNS with Rituximab(RTX).The study results show that RTX can prolong the remission period of PNS and reduce the dose and side effects of hormones and immunosuppressive agents.Moreover,some randomized controlled trials revealed that RTX can be used as a potential first-line drug for hormone-dependent or frequently-relapsing PNS or a second-line treatment for hormone-resistant PNS.In this article,the latest clinical trial designs and results of RTX in the treatment of PNS in children in recent years were summarized,so as to provide reference for the clinical practice and research of RTX in the treatment of PNS.

关 键 词：肾病综合征 儿童 利妥昔单抗 治疗 临床研究 

分 类 号：R726.9[医药卫生—儿科]