ISSN 1006-298X      CN 32-1425/R

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肾脏病与透析肾移植杂志 ›› 2021, Vol. 30 ›› Issue (1): 14-18.DOI: 10.3969/j.issn.1006298X.2021.01.003

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利妥昔单抗治疗冷球蛋白血症相关膜增生性肾小球肾炎的疗效

  

  • 出版日期:2021-02-28 发布日期:2021-02-27

Efficacy of rituximab in treatment of cryoglobulinaemic membranoproliferative glomerulonephritis

  • Online:2021-02-28 Published:2021-02-27

摘要: 目的:观察利妥昔单抗(RTX)治疗冷球蛋白血症相关膜增生肾小球肾炎(MPGN)患者的疗效及不良反应。
方法:回顾性分析8例经肾活检病理诊断为冷球蛋白血症相关MPGN患者的资料,接受RTX治疗并随访≥12月;RTX按单次375 mg/m2静脉输注。
结果:4例为乙型肝炎病毒(HBV)感染相关,4例原发病因不明确。所有患者均联合激素治疗,2例联合他克莫司治疗,4例HBV感染者予恩替卡韦抗病毒治疗。中位随访时间35(12~40)月,末次随访4例完全缓解,2例部分缓解,2例无效。RTX治疗中未观察到急性或慢性严重不良反应。
结论:RTX联合激素可成为冷球蛋白血症相关MPGN的治疗选择,其疗效及安全性较好,值得进一步深入研究。


关键词: 利妥昔单抗,冷球蛋白血症,膜增生肾小球肾炎,乙型肝炎病毒感染

Abstract: Objective:To observe the efficacy and side effects of rituximab(RTX) in the treatment of cryoglobulinaemic membranoproliferative glomerulonephritis(MPGN).
Methodology:Eight patients with biopsy proven cryoglobulinaemic MPGN were enrolled in this study. RTX was given intravenously at 375 mg/m2.
Results:Four patients were associated with HBV infection . All patients were treated with glucocorticosteroid therapy, combined with tacrolimus in 2 cases. Entecavir were prescribed to 4 patients with HBV infection. With a median followup of 35(12~40) months,4 cases achieved complete remission,2 cases achieved partial remission and 2 cases failed to respond. No acute or chronic serious adverse reactions were observed during RTX treatment.
Conclusion:RTX combined with glucocorticosteroid can be an effective and safe selection in patients with cryoglobulinaemic MPGN,which may be worthy of further study.


Key words: Rituximab, cryoglobulinaemia, membranoproliferative glomerulonephritis, hepatitis B virus infection