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利妥昔单抗对膜性肾病患者肾功能、抗M型磷脂酶A2受体抗体及血管生成素样蛋白-4水平的影响

Effects of Rituximab on renal function,anti-M-type phospholipase A2 receptor antibody,and angiopoietin-like protein-4 in patients with membranous nephropathy
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摘要 目的 探究奥美沙坦联合利妥昔单抗治疗膜性肾病对患者肾功能及抗M型磷脂酶A2受体(PLA2R)抗体、血管生成素样蛋白-4水平的影响。方法 选取2019年5月至2022年5月于江苏省徐州市中医院风湿肾病科接受治疗的膜性肾病患者72例,采用随机数字表法将其分为对照组和观察组,每组36例。对照组给予醋酸泼尼松片联合奥美沙坦治疗,观察组给予奥美沙坦酯片联合利妥昔单抗进行治疗。治疗6个月后,比较两组临床效果及肾功能指标、抗M型PLA2R抗体、血管生成素样蛋白-4、辅助性T(Th)细胞水平。随访3个月,记录两组不良反应发生情况。结果 治疗6个月后,观察组的疗效优于对照组,差异有统计学意义(P<0.05)。治疗6个月后,两组血尿素氮、肌酐、尿酸、抗M型PLA2R抗体、血管生成素样蛋白-4、Th17细胞、Th1细胞、Th2细胞水平均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05)。两组不良反应总发生率比较,差异无统计学意义(P>0.05)。结论 奥美沙坦联合利妥昔单抗治疗膜性肾病可以改善患者的肾功能,降低抗M型PLA2R抗体、血管生成素样蛋白-4水平,提高患者的治疗效果。 Objective To explore the effects of Olmesartan combined with Rituximab on renal function,anti-M-type phospholipase A2 receptor(PLA2R)antibody,and angiopoietin-like protein-4 levels in patients with membrane-induced nephropathy.Methods A total of 72 patients with membranous nephropathy treated in Department of Rheumatology and Nephrology of Xuzhou Hospital of Traditional Chinese Medicine,Jiangsu Province from May 2019 to May 2022 were selected and divided into control group and observation group by random number table method,with 36 cases in each group.The control group was treated with Prednisone Acetate Tablets combined with Olmesartan,and the observation group was treated with Olmesartan Medoxomil Tablets combined with Rituximab.After six months of treatment,the therapeutic effect,renal function index,anti-M-type PLA2R antibody,angiopoietin-like protein-4,and helper T(Th)cell levels were compared between the two groups.The patients were followed up for three months and the adverse reactions were recorded in both groups.Results After six months of treatment,the efficacy of observation group was better than that of control group,and the difference was statistically significant(P<0.05).After six months of treatment,the levels of blood urea nitrogen,creatinine,uric acid,anti-M-type PLA2R antibody,angiopoietin-like protein-4,Th17 cells,Th1 cells,and Th2 cells in two groups were lower than those before treatment,and those of observation group were lower than those of control group,the differences were statistically significant(P<0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion Olmesartan combined with Rituximab in the treatment of membrane nephropathy can improve the renal function of patients,reduce the levels of anti-M-type PLA2R antibody and angiopoietin-like protein-4,and improve the therapeutic effect of patients.
作者 盖维 顾向浩 周云 GAI Wei;GU Xianghao;ZHOU Yun(Department of Rheumatology and Nephrology,Xuzhou Hospital of Traditional Chinese Medicine,Jiangsu Province,Xuzhou 221000,China)
出处 《中国医药导报》 CAS 2023年第36期79-83,共5页 China Medical Herald
基金 江苏省中医药管理局科研项目(YB2020038)。
关键词 利妥昔单抗 奥美沙坦 膜性肾病 肾功能 抗M型磷脂酶A2受体抗体 血管生成素样蛋白-4 Olmesartan Rituximab Membrane nephropathy Renal function Anti-M-type phospholipase A2 receptor antibody Angiopoietin-like protein-4
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