ISSN 1006-298X      CN 32-1425/R

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肾脏病与透析肾移植杂志 ›› 2026, Vol. 35 ›› Issue (2): 175-179.DOI: 10.3969/j.issn.1006⁃298X.2026.02.015

• 肾脏病临床 • 上一篇    下一篇

狼疮肾炎患者停用免疫抑制治疗的研究进展

  

  • 出版日期:2026-04-28 发布日期:2026-04-23

Withdrawal of immunosuppressive therapy in the treatment of lupus nephritis

  • Online:2026-04-28 Published:2026-04-23

摘要: 狼疮肾炎 (LN) 患者常需长期接受糖皮质激素和 (或) 免疫抑制剂治疗,这种治疗模式虽可控制 LN 活动、预防复发,但不可避免出现药物毒副作用。因此,临床不断探索在疾病缓解后停用免疫抑制治疗。近年来研究证实,临床医生基于基线风险因素、缓解持续时间、缓解深度等多维度指标进行复发风险分层后,低复发风险患者在严密监测下可安全减量并停用糖皮质激素或免疫抑制剂,高复发风险患者推荐长期以最低有效剂量维持治疗。本文重点介绍 LN 患者停用免疫抑制治疗的临床研究及决策。

关键词: 狼疮肾炎, 停药, 糖皮质激素, 免疫抑制剂, 复发

Abstract: Patients with lupus nephritis (LN) often require long⁃term treatment with glucocorticoids and/or immunosuppressants.Despite its efficacy in controlling lupus nephritis and preventing renal relapse,prolonged immunosuppressive therapy is associated with unavoidable drug⁃related adverse events.Therefore,there is ongoing clinical exploration into safe withdrawal of immunosuppressive therapy after clinical remission.Recent studies have confirmed that it is feasible to safely taper off glucocorticoids or immunosuppressants in low⁃risk patients under close surveillance,with multidimensional assessment of relapse risk based on baseline risk factors,duration of sustained remission,and depth of remission.In contrast,high⁃risk patients should receive long⁃term maintenance therapy at the lowest effective dose.This review focuses on clinical research and decision⁃making regarding the withdrawal of immunosuppressive therapy in LN patients.