利妥昔单抗治疗儿童肾病综合征对其淋巴细胞亚群水平的影响

Effect of rituximab on lymphocyte subsets in children with nephrotic syndrome

目的 探究利妥昔单抗(RTX)治疗儿童肾病综合征对其淋巴细胞亚群水平的影响。方法 选取2020年5月至2022年5月安徽省儿童医院肾脏科收治的163例肾病综合征患儿作为研究对象,根据治疗方法的不同将患儿分为对照组83例和观察组80例,对照组给予糖皮质激素治疗,两组的基础上给予利妥昔单抗治疗。对比两组患儿的临床疗效、使用前后患儿的淋巴细胞亚群水平及两组患儿的不良反应发生情况。结果 对照组患儿疗效为84.34%,观察组患儿疗效为96.25%,观察组患儿疗效高于对照组,差异有统计学意义(χ^(2)=6.530,P<0.05)。治疗后,观察组的CD3+、CD3+CD4+T细胞、CD3-CD19+细胞计数高于对照组,差异有统计学意义(t=2.075,2.106,2.051,P<0.05);观察组的CD19+计数低于对照组,差异有统计学意义(t=2.094,P<0.05);观察组患儿CD3+CD8+T细胞计数与对照组比较,差异无统计学意义(t=0.214,P>0.05)。两组的不良反应发生率比较,差异无统计学意义(χ^(2)=2.045,P>0.05)。结论 利妥昔单抗对儿童肾病综合征的治疗效果明显,其可通过调节患儿机体的淋巴细胞亚群的水平达到治疗效果,且安全性较高。

Objective To explore the effect of rituximab(RTX)on the level of lymphocyte subsets in children with nephrotic syndrome.Methods A total of 163 children with nephrotic syndrome admitted to Anhui Children's Hospital from May 2020 to May 2022 were selected as the study objects.According to different treatment methods,the children were divided into the control group(83 cases)and the observation group(80 cases).The control group was given glucocorticoid therapy,and the observation group was given rituximab therapy on the basis of the control group.The clinical efficacy,the level of lymphocyte subsets before and after treatment and the occurrence of adverse reactions in the two groups were compared.Results The curative effect of the children in the control group was 84.34%,and the curative effect of the children in the observation group was 96.25%.The curative effect in the observation group was higher than that in the control group,the difference was significant(X^(2)=6.530,P<0.05).After treatment,the counts of CD3+,CD3+CD4+T cells and CD3-CD19+cells in the observation group was higher than those in the control group,and the difference was significant(t=2.075,2.106,2.051,P<0.05).The CD19+count in the observation group was lower than that in the control group,the difference was significant(t=2.094,P<0.05).There was no significant difference in CD3+CD8+T cell count between the observation group and the control group(t=0.214,P>0.05).There was no significant difference in the incidence of adverse reactions between the two groups(X^(2)=2.045,P>0.05).Conclusion Rituximab has an obvious therapeutic effect on children with nephrotic syndrome.It can achieve the therapeutic effect by regulating the level of lymphocyte subsets in the body of children,and it has high safety.