环磷酰胺治疗特发性膜性肾病的疗效

Cyclophosphamide in management of idiopathic membranous nephropathy

环磷酰胺(CTX)属于烷化剂类细胞毒性药物,作为免疫抑制剂和抗肿瘤药物广泛应用于临床,因其拥有较多的临床研究证据,成为改善全球肾脏病预后组织(KDIGO)推荐的治疗特发性膜性肾病(IMN)的首选药物,推荐级别为1B。然而由于CTX的致癌性等副作用,应用CTX治疗IMN的剂量和使用方法仍存在一定争议。本文就CTX治疗IMN的疗效机制、安全性及与其他药物的对比作一综述。

Cyclophosphamide（ CTX）,an alkylating agent,is widely used as an immunosuppressive agent and antitumor drug. Because of abundant clinical research evidences,KDIGO recommended CTX as the preferred treatment for idiopathic membranous nephropathy（ IMN）,recommend level 1 B. However,due to the carcinogenesis and other side effects,the dose and method of CTX treatment of IMN is still under controversy. This article will review the mechanism,clinical efficacy,safety,medication pathways and the differences from other IMN medicines of cyclophosphamide.