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原发性肾病综合征(PNS)是儿童时期常见的肾小球疾病,约25%的频复发型肾病综合征(FRNS)或激素依赖型肾病综合征(SDNS)患儿在成年期仍需用激素和(或)免疫抑制剂(ISA)维持治疗;约35%的激素耐药型肾病综合征(SRNS)患儿加用免疫抑制剂仍不缓解。利妥昔单抗是一种人鼠嵌合型抗CD20单克隆抗体,作为PNS的三线药物用于治疗对ISA如环磷酰胺、环孢素、他克莫司、霉酚酸酯等反应不佳、且不良反应严重的FRNS/SDNS和SRNS患儿,已取得较好的近期疗效,其远期疗效及安全性尚需多中心、前瞻性、大样本的随机对照试验证实。
Primary nephrotic syndrome (PNS) is a common childhood glomerular disease. About 25% of children with frequent relapsing nephrotic syndrome (FRNS) or hormone-dependent nephrotic syndrome (SDNS) are still required during adulthood Hormone and / or immunosuppressant (ISA) maintenance therapy; about 35% of steroid resistant nephrotic syndrome (SRNS) children with immunosuppressive agents are still not relieved. Rituximab is a human mouse chimeric anti-CD20 monoclonal antibody that is used as a third-line drug for PNS to treat reactions to ISA, such as cyclophosphamide, cyclosporine, tacrolimus, mycophenolate, etc. Good, and adverse reactions in patients with severe FRNS / SDNS and SRNS have achieved better short-term efficacy, its long-term efficacy and safety still need more centers, prospective, large sample of randomized controlled trials confirmed.