血清磷脂酶A2受体抗体预测利妥昔单抗治疗特发性膜性肾病疗效价值的初探  

Serumanti-PLA2R antibody predicted treatment outcome in idiopathic membranous nephropathy

作　　者：张雪琴[1] 姜鸿[1] 杨淑芬[1] 赵红娟[1] 陆晨[1] Zhang Xue-qin;Jiang Hong;Yang Shu-fen;Zhao Hong-juan;Lu Chen(Department of Nephrology,People's Hospital of Xinjiang Uygur Autonomous Region,Urumqi 830001,China)

机构地区：[1]新疆维吾尔自治区人民医院肾病科,乌鲁木齐830001

出　　处：《临床肾脏病杂志》2021年第3期206-209,共4页Journal Of Clinical Nephrology

摘　　要：目的探索血清磷脂酶A2受体抗体预测利妥昔单抗治疗特发性膜性肾病疗效的预测价值。方法纳入2017年8月1日至2020年5月31日新疆维吾尔自治区人民医院首次确诊或长期随访使用利妥昔单抗治疗的特发性膜性肾病的患者120例,依据血清磷脂酶A2受体抗体情况将患者分为阳性组和阴性组,进行组间资料比较,用Kaplan-Meier法分析各组缓解率,用log-rank检验比较组间缓解率,Cox单因素及多因素风险回归模型调整影响疗效的因素。结果血清磷脂酶A2受体抗体阳性的87例患者中,分别有9.1%和6.9%达到部分及完全缓解,而血清磷脂酶A2受体抗体阴性组达到部分及完全缓解率达到27.3%和24.2%,PLA2R-Ab阳性组使用利妥昔单抗治疗后达到部分及完全缓解率均高于阴性组(χ^(2)=5.057,P=0.0245;χ^(2)=7.506,P=0.0061)。结论血清磷脂酶A2受体抗体阳性的特发性膜性肾病患者使用利妥昔单抗治疗的疗效差。血清磷脂酶A2受体抗体是预测特发性膜性肾病患者使用利妥昔单抗疗效的预测因子。Objective To explore the predictive value of serum phospholipase A2 receptor antibody in determining the efficacy of rituximab in the treatment of idiopathic membranous nephropathy(IMN).Methods From August 1,2017 to May 31,2020,a total of 120 IMN patients received rituximab for the first time or during long-term follow-ups were included.According to the serum level of phospholipase A2 receptor antibody,they were divided into the groups of positive and negative.The relevant data were compared between two groups.The remission rate of each group was analyzed by Kaplan Meier method and the remission rate between groups compared by log-rank test.Cox univariate and multivariate risk regression models were employed for adjusting the influencing factors of efficacy.Results Among 87 patients with positive serum phospholipase A2 receptor antibody,9.1%and 6.9%achieved partial and complete remission versus 27.3%and 24.2%in serum phospholipase A2 receptor antibody negative group.The partial and complete remission rates after treatment with rituximab were higher in pla2R-Ab positive group than those in negative group(χ^(2)=5.057,P=0.0245;χ^(2)=7.506,P=0.0061).Conclusion The efficacy of rituximab is poor in the treatment of idiopathic membranous nephropathy with positive serum phospholipase A2 receptor antibody.Serum phospholipase A2 receptor antibody is an efficacy predictor of rituximab in IMN patients.

关 键 词：特发性膜性肾病 血清磷脂酶A2受体抗体 利妥昔单抗 疗效 

分 类 号：R692[医药卫生—泌尿科学]