局灶节段性肾小球硬化的治疗现状

Current treatment of focal segmental glomerulosclerosis

局灶节段性肾小球硬化(FSGS)是常见的肾小球疾病,临床主要表现肾病综合征。对治疗的反应与疾病预后密切相关,蛋白尿缓解的患者预后良好。糖皮质激素和神经钙蛋白抑制剂(CNI)是目前治疗特发性FSGS的主要药物,部分患者疗效好,但部分患者对激素及CNI治疗抵抗,肾功能迅速恶化;对于这些难治性患者的治疗目前还寄望于新型药物的研发。随着人们对FSGS发病机制的研究深入,研发出了针对更多治疗靶点的药物,但其疗效仍待临床进一步验证。本文将对FSGS的治疗现状进行综述。

Focal segmental glomerulosclerosis （FSGS） is a common primary glomerular disorder. The prognosis of FSGS is closely related to the reponse of treatment. Glucocoticosteroid and calcineurin inhibitors are the first-line drugs in the treatment of FSGS patients with nephrotic syndrome. Most patients can attain remission of proteinuria and have a good prognosis. However, some of the patients have sustained massive proteinuria, despite treated by a variety of drugs, and evolve to ESRD rapidly. For these refractory patients, new drugs may bring the hope of mend. In pace with understanding of the pathogenesis of FSGS, more therapeutic targets and drugs have developed, but the curative effect should be further tested and verified.