特发性膜性肾病的临床治疗进展

Clinical Treatment Progress of Idiopathic Membranous Nephropathy

特发性膜性肾病(IMN)是成人肾病综合征(NS)的常见的病理类型之一,由于其治疗方案繁多,故初始治疗方案的制定至关重要。西医治疗方面在激素联合烷化剂等方案的基础上,钙调磷酸酶抑制剂的临床应用也得到了KDIGO指南的推荐,而其他非免疫抑制治疗,如利妥昔单抗、促肾上腺皮质激素、咪唑立宾等因研究样本较小,暂未得到临床的广泛应用,仅在严重NS、应用标准免疫抑制治疗无效时才考虑选用。故查阅近5年国内外文献,对IMN的治疗现状作综述如下。

Idiopathic membranous nephropathy( IMN) is one of the common pathological types of adult nephrotic syndrome( NS). Due to its many treatment options,the initial treatment plan is crucial. On the basis of hormone combined with alkylating agents and other programs,the clinical application of calcineurin inhibitors also have been recommended by the KDIGO guidelines,while other non-immunosuppressive treatments,such as rituximab,adrenocorticotropic hormone and imidazole,because of the small sample size,have not been widely used in clinical practice and it is only considered when the severe NS and the standard immunosuppressive therapy are ineffective. Therefore,the literature on the domestic and foreign literature for the past 5 years is reviewed. The summary is as follows.