利妥昔单抗联合他克莫司治疗膜性肾病患者的效果  

Effects of Rituximab combined with Tacrolimus in treatment of patients with membranous nephropathy

作　　者：韩青 HAN Qing(Department of Kidney and Rheumatology of Shuyang Hospital,Suqian 223600 Jiangsu,China)

机构地区：[1]沭阳医院肾脏风湿科,江苏宿迁223600

出　　处：《中国民康医学》2025年第5期54-56,60,共4页Medical Journal of Chinese People’s Health

摘　　要：目的:观察利妥昔单抗联合他克莫司治疗膜性肾病患者的效果。方法:回顾性分析2021年8月至2024年8月该院收治的80例膜性肾病患者的临床资料,根据治疗方案不同将其分为对照组和观察组各40例。对照组采用他克莫司治疗,观察组在对照组基础上联合利妥昔单抗治疗,比较两组临床疗效,治疗前后肾功能指标[估算肾小球滤过率(eGFR)、24 h尿蛋白定量、尿微量白蛋白(UAlb)、UAlb/肌酐(UCr)(UACR)]、肾病相关细胞因子指标[B细胞活化因子(BAFF)、肾损伤分子-1(KIM-1)、抗M型磷脂酶A2受体(PLA2R)抗体、血管生成素样蛋白-4(Angptl4)]水平,以及不良反应发生率。结果:观察组治疗总有效率为90.00%(36/40),高于对照组的65.00%(26/40),差异有统计学意义(P<0.05);治疗后,两组eGFR水平均高于治疗前,且观察组高于对照组,两组24 h尿蛋白定量、UAlb、UACR水平均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);两组BAFF、KIM-1、PLA2R抗体、Angptl4水平均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:利妥昔单抗联合他克莫司治疗膜性肾病患者可提高治疗总有效率,改善肾功能指标水平,以及降低肾病相关细胞因子指标水平的效果优于单纯他克莫司治疗。Objective:To observe effects of Rituximab combined with Tacrolimus in treatment of patients with membranous nephropathy.Methods:The clinical data of 80 patients with membranous nephropathy admitted to this hospital from August 2021 to August 2024 were retrospectively analyzed.According to different medication regimens,they were divided into control group and observation group,40 cases in each group.The control group was treated with Tacrolimus,while the observation group was treated with Rituximab on the basis of that of the control group.The clinical efficacy,the levels of renal function indexes [estimated glomerular filtration rate(eGFR),24 h urine protein,urinary microalbumin(UAlb),UAlb/creatinine(UCr)(UACR)] and renal related cytokine indexes [B cell activating factor(BAFF),kidney injury molecule-1(KIM-1),anti-M-type phospholipase a 2 receptor(PLA2R antibody,angiopoietin-like protein-4(Angptl4)] before and after the treatment,and the incidence of adverse reactions were compared between the two groups.Results:The total effective rate of the observation group was 90.00%(36/40),which was higher than 65.00%(26/40) of the control group,and the difference was statistically significant(P<0.05).After the treatment,the eGFR levels of the two groups were higher than those before the treatment,and that in the observation group was higher than that in the control group;the levels of 24 h urine protein,UAlb and UACR in th two groups were lower than those before the treatment,and those in the observation group were lower than those in the control group;and the differences were statistically significant(P<0.05).The levels of BAFF,KIM-1,PLA2 R antibody and Angptl4 in the two groups were lower than those before the treatment,those in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).However,there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions:Rituximab combined with Tacrolimus in the treatm

关 键 词：膜性肾病 利妥昔单抗 他克莫司 肾功能 不良反应 

分 类 号：R692.3[医药卫生—泌尿科学]