利妥昔单抗治疗对特发性膜性肾病患者临床效果及安全性的影响

Effects of Rituximab on Clinical Efficacy and Safety of Patients with Idiopathic Membranous Nephropathy

目的:分析利妥昔单抗治疗特发性膜性肾病的效果及安全性。方法:回顾性分析上饶市人民医院肾内科2022年1月—2023年5月收治的62例特发性膜性肾病患者的临床资料,所有患者均初始进行利妥昔单抗治疗。记录患者治疗前及治疗后1、3、6、12个月的24 h尿蛋白定量、血肌酐(Scr)、白蛋白(ALB)、抗磷脂酶A2受体(PLA2R)抗体、CD19+B细胞计数,并分析临床疗效和安全性。结果:治疗后3、6、12个月患者的24 h尿蛋白定量较治疗前均下降,ALB较治疗前均上升,治疗后1、3、6、12个月患者的抗PLA2R抗体、CD19+B细胞计数较治疗前均显著下降,差异均有统计学意义(P<0.05);治疗后12个月,62例特发性膜性肾病患者完全缓解35例,占比56.45%;部分缓解24例,占比38.71%;未缓解3例,占比4.84%;总有效59例,占比95.16%;治疗期间,62例特发性膜性肾病患者中仅2例发生输液反应,减慢输液速度后好转。结论:利妥昔单抗治疗特发性膜性肾病安全有效。

Objective:To analyze the clinical efficacy and safety of Rituximab in the treatment of idiopathic membranous nephropathy.Method:The clinical data of 62 patients with idiopathic membranous nephropathy admitted to Department of Nephrology,Shangrao People's Hospital from January 2022 to May 2023 were retrospectively analyzed.All patients were initially treated with Rituximab.24 h urinary protein quantity,serum+creatinine(Scr),albumin(ALB),anti-phospholipase A2 receptor(PLA2R)antibody,and CD19 B cell count of patients were recorded before treatment and 1,3,6,and 12 months after treatment,and the clinical efficacy and safety were analyzed.Result:3,6 and 12 months after treatment,the 24 h urinary protein quantity of patients was decreased compared with that before treatment,and ALB was increased compared with that before treatment,1,3,+6 and 12 months after treatment,the anti-PLA2R antibody and CD19 B cell count of patients were significantly decreased compared with those before treatment,the differences were statistically significant(P<0.05).12 months after treatment,35 of 62 patients with idiopathic membranous nephropathy had complete remission,accounting for 56.45%;there were 24 cases with partial remission,accounting for 38.71%;there were 3 cases without remission,accounting for 4.84%,and a total of 59 cases were effective,accounting for 95.16%.During the treatment period,only 2 of 62 patients with idiopathic membranous nephropathy had an infusion reaction,which improved after slowing down the infusion speed.Conclusion:Rituximab is safe and effective in the treatment of idiopathic membranous nephropathy.