利妥昔单抗在膜性肾病患者中的治疗效果及对T淋巴细胞水平的影响研究

Study on the Therapeutic Effect of Rituximab in Patients with Membranous Nephropathy and Its Influence on T Lymphocyte Levels

目的:研究利妥昔单抗在膜性肾病患者中的治疗效果及对T淋巴细胞水平的影响。方法:选取2022年1月至2023年4月丰城市人民医院收治的膜性肾病患者80例,按照随机数字表法分为2组,其中对照组采用环孢素和小剂量糖皮质激素治疗,研究组采用利妥昔单抗静脉滴注治疗。比较两组临床疗效、T淋巴细胞亚群(CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))水平、肾功能[血肌酐(Scr)、24h尿蛋白定量、血尿酸(BUA)、白蛋白(ALB)]及不良反应。结果:与对照组相比,研究组治疗总有效率高;研究组CD4^(+)及CD4^(+)/CD8^(+)水平较低,CD8^(+)水平较高;研究组Scr水平、24h尿蛋白定量及BUA水平较低,ALB水平较高,上述差异均有统计学意义(P<0.05)。且两组不良反应比较,无统计学差异(P>0.05)。结论:膜性肾病患者采用利妥昔单抗治疗,效果显著,可有效改善患者T淋巴细胞亚群水平,提升肾功能,且较为安全。

Objective:To study the therapeutic effect of rituximab in patients with membranous nephropathy and its effect on T lymphocyte levels.Methods:80 patients with membranous nephropathy treated in Fengcheng people’s Hospital from January 2022 to April 2023 were selected and divided into two groups according to the random number table method.The control group was treated with cyclosporine and low-dose glucocorticoid,and the study group was treated with rituximab intravenous infusion.The clinical efficacy,T lymphocyte subsets(CD4^(+),CD8^(+),CD4^(+)/CD8^(+)),renal function[serum creatinine(SCR),24h urinary protein quantification,serum uric acid(BUA),albumin(ALB)]and adverse reactions were compared between the two groups.Results:compared with the control group,the total effective rate of the study group was higher;The levels of CD4^(+)and CD4^(+)/CD8^(+)in the study group were lower,while the level of CD8^(+)was higher;The SCR level,24h urinary protein quantification and BUA level in the study group were lower,while the alb level was higher,and the above differences were statistically significant(P<0.05).There was no significant difference in adverse reactions between the two groups(P>0.05).Conclusion:Rituximab is effective in the treatment of patients with membranous nephropathy,which can effectively improve the level of T lymphocyte subsets and renal function,and is relatively safe.