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肾脏病与透析肾移植杂志 ›› 2026, Vol. 35 ›› Issue (1): 56-61.DOI: 10.3969/j.issn.1006-298X.2026.01.012

• 医学继续教育 • 上一篇    下一篇

Alport 综合征治疗现状和进展

  

  • 出版日期:2026-02-27 发布日期:2026-02-27

Advances in therapies for Alport syndrome

  • Online:2026-02-27 Published:2026-02-27

摘要: Alport 综合征 (AS) 是一种由编码 Ⅳ 型胶原蛋白 α 链的基因发生致病性突变导致的遗传性肾病,目前尚无治愈手段。标准治疗为肾素 - 血管紧张素 - 醛固酮系统阻断剂,可显著延缓疾病进展,但仍有相当一部分患者在青少年或中年时期进展至终末期肾病。近年来,新型药物如钠 - 葡萄糖协同转运蛋白 2 抑制剂、新一代非甾体类盐皮质激素受体拮抗剂、内皮素受体拮抗剂等在动物模型和初步临床研究中展现出潜力,但需更多循证证据支持。基因治疗取得突破性进展,可部分恢复基膜胶原结构。干细胞疗法在修复基膜缺陷方面具有前景,但临床转化仍需验证。本文系统综述了 AS 的传统治疗现状与新兴疗法的研究进展,为临床实践和科研方向提供参考。

关键词: Alport 综合征, 治疗, 肾素 - 血管紧张素 - 醛固酮系统阻断剂, 基因治疗, 干细胞疗法

Abstract: Alport syndrome (AS) is a hereditary nephropathy caused by pathogenic variants in genes encoding type Ⅳ collagen α chains, with no strategies currently. Standard therapy involves renin-angiotensin-aldosterone system inhibitors, which significantly delay progression to end stage kidney disease. However, a proportion of patients still progressed to end stage kidney disease during adolescence or middle adulthood. Recently, studies in animal models and preclinical trials highlight the potential of novel agents, such as sodium-glucose cotransporter 2 inhibitors, next-generation non-steroidal mineralocorticoid receptor antagonists, and endothelin receptor antagonists, though further evidence-based validations are required. Gene therapy has made a breakthrough and shown partial restoration of glomerular basement membrane collagen architecture. Stem cell therapy holds potential for repairing glomerular basement membrane defects, but clinical translation requires validation. This review summarizes the current standard treatment and emerging therapies for AS, providing insights for clinical practice and future research.

Key words: Alport syndrome, therapy, renin-angiotensin-aldosterone system inhibitor, gene therapy, stem cell therapy