利妥昔单抗单药治疗成人微小病变肾病的疗效分析  

Efficacy of rituximab monotherapy in the treatment of adult minimal change disease

作　　者：王凤梅 魏青[1] 杨艳 张晓良[1] 王彬 Wang Fengmei;Wei Qing;Yang Yan;Zhang Xiaoliang;Wang Bin(Department of Nephrology,ZhongDa Hospital,Institute of Nephrology,School of Medicine,Southeast University,Nanjing 271200,China)

机构地区：[1]东南大学附属中大医院肾内科,南京271200

出　　处：《中华肾脏病杂志》2024年第12期946-951,共6页Chinese Journal of Nephrology

基　　金：国家自然科学基金(82060132);江苏省科技计划专项资金(重点研发计划社会发展)(BE2023770);南京市卫生健康委科技发展项目(KJZC-2021ZXNS11)。

摘　　要：目的探讨利妥昔单抗(rituximab,RTX)单药治疗成人微小病变肾病(minimal change disease,MCD)的疗效。方法本研究为病例系列分析,回顾性分析2021年1月至2023年10月于东南大学附属中大医院肾内科接受RTX单药治疗的10例MCD患者的临床资料。结果10例患者发病年龄为(48.4±21.2)岁;男性7例,女性3例;60岁以上患者4例(4/10)。利妥昔单抗治疗1次、2次和3次的患者分别为1例(1/10)、6例(6/10)和3例(3/10)。随访时间为(327.1±141.6)d。10例患者均在3个月内完全缓解,其中4例(4/10)在1个月内达到完全缓解,达到完全缓解的平均时间为35.7 d。随访中,10例患者均未复发。在治疗及随访过程中,未发现有明显不良反应。结论RTX单药治疗对MCD患者有效,但需要多中心、大样本的临床研究验证。此外RTX单药治疗后仍需密切随访患者,观察其长期疗效和安全性。Objective To investigate the efficacy of rituximab(RTX)monotherapy in the treatment of adult minimal change disease(MCD).Methods This study was a case series analysis.The clinical data of 10 MCD patients who received RTX monotherapy at the Department of Nephrology,Zhongda Hospital,Southeast University,from January 2021 to October 2023 were retrospectively conducted.Results The onset age of the 10 patients was(48.4±21.2)years old,including 7 males and 3 females.Four patients(4/10)were aged 60 or above.One patient(1/10),6 patients(6/10)and 3 patients(3/10)were treated with rituximab once,2 times and 3 times,respectively.The follow-up duration was(327.1±141.6)d.All 10 patients achieved complete remission within 3 months,with 4 cases(4/10)achieving complete remission within 1 month.The mean time to remission was 35.7 d.During the follow-up period,none of the 10 patients experienced relapse.No significant adverse reactions were observed during treatment and follow-up.Conclusion Rituximab monotherapy demonstrates effective treatment outcomes in patients with MCD,but multi-center,large sample clinical validation is required.Long-term follow-up is necessary to assess its sustained efficacy and safety.

关 键 词：利妥昔单抗 药物疗法 治疗结果 预后 微小病变肾病 

分 类 号：R692[医药卫生—泌尿科学]