利妥昔单抗治疗儿童频复发或激素依赖型肾病综合征的研究进展

Research advances of rituximab in the treatment of children with frequent relapse or steroid-dependent nephrotic syndrome

原发性肾病综合征(idiopathic nephrotic syndrome,INS)是儿童时期最常见并具有挑战性的一种肾小球疾病,大多数患儿对糖皮质激素治疗反应良好,但多达50%的患儿表现为激素依赖型或频复发型肾病综合征,所以其治疗方案的选择仍是目前临床治疗INS的难点之一。利妥昔单抗应用于治疗肾病综合征取得良好的疗效,但各个中心对利妥昔单抗治疗方案的选择不同,疗效亦不同。本文旨在对激素依赖型或频复发型肾病综合征患儿选择不同利妥昔单抗治疗方案的有效性、相应风险等方面进行综述。

Idiopathic nephrotic syndrome(INS)is the most common and challenging glomerular disease in childhood and most children respond favorably to glucocorticoid therapy.However,up to half of INS patients present with steroid-dependent or frequently-relapsing nephrotic syndrome so that selecting proper treatment regimens has remained one great clinical challenge.Rituximab(RTX)for nephrotic syndrome is generally efficacious.However,clinical outcomes vary greatly at different centers.This review summarized the effectiveness and risk of different RTX protocols for children with steroid-dependent or frequently-relapsing nephrotic syndrome.