摘要
目的分析利妥昔单抗联合糖皮质激素治疗特发性膜性肾病(IMN)的效果。方法队列研究。抽取2019年5月至2022年4月济源市人民医院收治的IMN患者68例,按随机数字表法分为对照组和观察组,每组34例。对照组采用糖皮质激素治疗,观察组采用利妥昔单抗联合糖皮质激素治疗。比较两组疗效、血液和尿液生化指标[血清白蛋白(ALB)、24 h尿蛋白定量、血肌酐(Scr)、血尿酸(BUA)]、25羟维生素D3[25(OH)D3]、中性粒细胞明胶酶相关脂质运载蛋白(NGAL)、免疫功能[T淋巴细胞(CD4^(+)、CD8^(+))]及不良反应发生率。结果观察组总有效率(73.53%,25/34)高于对照组(50.00%,17/34),P<0.05。治疗后,观察组ALB水平高于对照组,24 h尿蛋白定量、Scr、BUA水平低于对照组(P<0.05);治疗后,观察组25(OH)D3水平高于对照组,NGAL水平低于对照组(P<0.05);治疗后,观察组CD4^(+)水平低于对照组,CD8^(+)水平高于对照组(P<0.05)。观察组不良反应发生率(17.65%,6/34)与对照组(11.76%,4/34)比较差异未见统计学意义(P>0.05)。结论利妥昔单抗联合糖皮质激素治疗IMN效果显著,能改善机体血液、尿液生化指标和细胞因子水平,提升患者免疫功能,且不会增加不良反应的发生。
Objective To analyze the therapeutic effect of rituximab combined with glucocorticoids on idiopathic membranous nephropathy(IMN).Methods Sixty-eight patients with IMN treated in Jiyuan People’s Hospital from May 2019 to April 2022 were selected for the cohort study.And they were divided into a control group and an observation group by random number table method,with 34 cases in each group.The control group was treated with glucocorticoids,and the observation group was treated with rituximab combined with glucocorticoids.The curative effect,blood and urine biochemical indicators,including serum albumin(ALB),24-hour urine protein quantification,serum creatinine(Scr)and blood uric acid(BUA),serum 25 hydroxyvitamin D3,referred to as 25(OH)D3,and neutrophil gelatinase-associated lipocalin(NGAL),immune function assessed by T lymphocytes,including cluster of differentiation 4^(+)(CD4^(+))and cluster of differentiation 8^(+)(CD8^(+)),and the incidences of adverse reactions were compared between the two groups.Results The total effective rate in the observation group was 73.53%(25/34),higher than the 50.00%(17/34)in the control group(P<0.05).After treatment,the ALB level in the observation group was higher than that in the control group,while levels of 24-hour urine protein quantification,Scr,and BUA in the observation group were lower than those in the control group(P<0.05).After treatment,the 25(OH)D3 level in the observation group was higher,and the NGAL level was lower compared with the control group(P<0.05).After treatment,the observation group had lower CD4^(+) and higher CD8^(+)level compared with the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the observation group(17.65%,6/34)and the control group(11.76%,4/34),P>0.05.Conclusions Rituximab combined with glucocorticoids has a significant effect in the treatment of IMN;this protocol can improve the body’s blood,urine biochemical indicators and level of cytokine,enhance the immune function of patients,and does not increase the incidence of adverse reactions.
作者
卢艳
王柯
段丽娜
Lu Yan;Wang Ke;Duan Lina(Department of Nephrology,Jiyuan People’s Hospital,Jiyuan 459000,China)
出处
《中国实用医刊》
2024年第20期83-86,共4页
Chinese Journal of Practical Medicine
关键词
膜性肾病
利妥昔单抗
糖皮质激素
Glomerulonephritis,membranous
Rituximab
Glucocorticoids
