利妥昔单抗联合环磷酰胺治疗特发性膜性肾病患者的效果  

Effects of Rituximab combined with Cyclophosphamide in treatment of patients with idiopathic membranous nephropathy

作　　者：吴本利 WU Benli(Department of Nephrology of Boai County People’s Hospital,Jiaozuo 454450 Henan,China)

机构地区：[1]博爱县人民医院肾内科,河南焦作454450

出　　处：《中国民康医学》2025年第6期26-28,32,共4页Medical Journal of Chinese People’s Health

摘　　要：目的:观察利妥昔单抗联合环磷酰胺治疗特发性膜性肾病患者的效果。方法:回顾性分析2021年4月至2023年9月该院收治的60例特发性膜性肾病患者的临床资料,按照治疗方法不同将其分为观察组和对照组各30例。两组均给予对症治疗,在此基础上,对照组给予环磷酰胺治疗,观察组在对照组基础上联合利妥昔单抗治疗,两组均治疗6个月。比较两组临床疗效,治疗前后肾功能指标[24 h尿蛋白定量、白蛋白(ALB)、血尿素氮(BUN)、抗磷脂酶A2受体(PLA2R)抗体]、T细胞亚群指标(CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))、B细胞亚群指标(CD19^(+)、CD20^(+))水平,以及不良反应发生率。结果:观察组治疗总有效率为86.67%(26/30),高于对照组的56.67%(17/30),差异有统计学意义(P<0.05);治疗后,两组ALB水平均高于治疗前,且观察组高于对照组,两组BUN、PLA2R抗体、24 h尿蛋白定量水平均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);治疗后,两组CD8^(+)水平均高于治疗前,且观察组高于对照组,两组CD4^(+)、CD4^(+)/CD8^(+)、CD19^(+)、CD20^(+)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:利妥昔单抗联合环磷酰胺治疗特发性膜性肾病患者可提高治疗总有效率,改善肾功能指标、T细胞亚群指标、B细胞亚群指标水平,效果优于单纯环磷酰胺治疗。Objective:To observe effects of Rituximab combined with Cyclophosphamide in treatment of patients with idiopathic membranous nephropathy.Methods:The clinical data of 60 patients with idiopathic membranous nephropathy admitted to this hospital from April 2021 to September 2023 were retrospectively analyzed.According to different treatment methods,they were divided into observation group and control group,30 cases in each group.Both groups were given symptomatic treatment.On this basis,the control group was treated with Cyclophosphamide,while the observation group was treated with Rituximab on the basis of that of the control group.Both groups were treated for 6 months.The clinical efficacy,the levels of renal function indexes[24 h urinary protein quantification,albumin(ALB),blood urea nitrogen(BUN),anti-phospholipase A2 receptor(PLA2R)antibody],T cell subsets indexes(CD4^(+),CD8^(+),CD4^(+)/CD8^(+))and B cell subsets indexes(CD19^(+),CD20^(+))levels 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 86.67%(26/30),which was higher than 56.67%(17/30)of the control group,and the difference was statistically significant(P<0.05).After the treatment,the levels of ALB in 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 BUN,PLA2R antibody and 24 h urine protein in the 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).After the treatment,the levels of CD8^(+)in 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 CD4^(+),CD4^(+)/CD8^(+),CD19^(+)and CD20^(+)in the two groups were lower than those before the treatment,and those in the observation group were lower than those in t

关 键 词：特发性膜性肾病 利妥昔单抗 环磷酰胺 肾功能 T细胞亚群 B细胞亚群 不良反应 

分 类 号：R692[医药卫生—泌尿科学]