回顾性分析利妥昔单抗治疗肾小球疾病临床疗效

Retrospective Analyse of the Clinical Effect of Rituximab in the Treatment of Glomerular Disease

目的分析利妥昔单抗(RTX)治疗肾小球疾病的起效时间及短期内的临床效果。方法抽取某三甲医院2021年1月—2022年12月使用RTX治疗肾小球疾病的病例资料,分析患者使用RTX规范治疗过程中血常规、肝功能、肾功能、免疫等相关指标变化,观察短期内临床疗效及安全性。结果共调取52例患者资料,其中30例接受RTX规范治疗,在随访期内血浆白蛋白出现上升趋势,24 h尿蛋白、B细胞计数出现下降趋势,治疗3、6个月后与治疗前比较差异有统计学意义(P<0.05);RTX治疗第1、2、3、4针后及3、6个月后临床缓解率分别为26.92%、36.00%、51.85%、57.69%、76.92%、81.82%;在随访期内无严重不良反应发生。结论RTX能够改善肾小球相关疾病的24 h尿蛋白、血浆白蛋白水平以及B细胞计数,稳定肾功能,且安全性较好。

Objective To analyze the onset time and short-term clinical effect of rituximab(RTX)in the treatment of glomerular diseases.Methods All case data of rituximab used in the treatment of glomerular diseases in a tertiary hospital from January 2021 to December 2022 were extracted for retrospective study.The changes in blood routine,liver function,kidney function,immunity and other related indexes were analyzed after the treatment of RTX and the clinical effect in the short term was observed.Results A total of 52 patients were collected,of which 30 received RTX standardized therapy.During the follow-up period,plasma albumin showed an upward trend,and the 24-hour urine protein and B cell count showed a downward trend.The values of these indexes after 3 months and 6 months after treatment were significantly different from those before treatment,which was statistically significant(P<0.05).The clinical response rates after the first injection,the second injection,the third injection,the fourth injection,3 months later,and 6 months after RTX treatment were 26.92%,36.00%,51.85%,57.69%,76.92%and 81.82%,respectively.No serious adverse effects occurred during the follow-up period.Conclusions RTX can improve 24-hour urine protein,plasma albumin level and B cell count in glomerular-related diseases,stabilize renal functionand have good safety.