特发性膜性肾病的治疗研究进展

Advances in the treatment of idiopathic membranous nephropathy

特发性膜性肾病(idiopathic membranous nephropathy,IMN)是成年人肾病综合征最常见的病因,约三分之一的IMN患者发展为终末期肾病。IMN的治疗成为近年来值得关注的热点。血管紧张素转换酶抑制剂(angiotensin-converting enzyme inhibitor,ACEI)/血管紧张素受体拮抗剂(angiotensin receptor antagonists,ARB)因降低肾小球灌注压、减少蛋白尿等机制起到保护肾脏的作用而作为治疗IMN的主要方法之一,包括免疫抑制剂、利妥昔单抗、中医中药、促肾上腺皮质激素等在治疗IMN方面积累了越来越多的经验。该文就IMN的治疗研究进展作一综述。

Idiopathic membranous nephropathy（ IMN） is the most common cause of nephrotic syndrome in adults. About one-third of the IMN patients develop end-stage renal disease. The treatment of IMN has become a hot spot in recent years. Angiotensin-converting enzyme inhibitor（ ACEI） and angiotensin receptor antagonists（ ARB） are the main methods to treat IMN due to their reducing glomerular perfusion pressure and proteinuria and other mechanisms to protect the function of the kidneys. More and more medications have accumulated experience in the treatment of IMN including immunosuppressive agents,rituximab,traditional Chinese medicine,and adrenocorticotropic hormone（ ACTH）. We review the treatment progress of IMN in this paper.