难治性特发性膜性肾病诊治进展

Progress in diagnosis and treatment of refractory idiopathic membranous nephropathy

膜性肾病是肾病综合征的病理类型之一,在成人中最常见,按病因可分为特发性膜性肾病(IMN)和继发性膜性肾病(SNM)两类。研究表明,在给予特发性膜性肾病患者激素联合免疫抑制治疗的情况下,多数患者疗效较好,但仍有30%的IMN患者表现为持续性NS,被称为难治性IMN (RIMN)。目前国内外对于RIMN患者治疗的研究仍处于探索阶段,如何早期识别难治性特发性膜性肾病,如何制定个体化的治疗方案,是临床工作中棘手的问题之一。本文就RIMN的早期识别及治疗进展作一综述,旨在提高RIMN的临床疗效,改善患者预后。

Membranous nephropathy is one of the pathological types of nephrotic syndrome,it is the most common in adults.According to the cause,it can be divided into idiopathic membranous nephropathy(IMN)and secondary membranous nephropathy(SNM).Studies have shown that treated by hormones combined with immunosuppressive therapy,most patients with idiopathic membranous nephropathy have better curative effects,however,30%of IMN patients still have persistent NS,which is called refractory IMN.At present,researches on the treatment of RIMN patients at home and abroad are still in the exploratory stage.How to identify refractory idiopathic membranous nephropathy(RIMN)early,and how to develop an individualized treatment plan is still one of the thorny issues in clinical work.This article reviews the progress of early recognition and treatment of RIMN,aiming to improve the clinical efficacy of RIMN and improve the prognosis of patients.