中国实用内科杂志2024，Vol.44Issue(1)：59-63,5.DOI:10.19538/j.nk2024010111
低剂量与标准剂量利妥昔单抗治疗原发性膜性肾病临床疗效分析
Efficacy of low-dose and standard-dose Rituximab in patients with primary membranous nephropathy
刘爱春 1梁耀先 1赵新菊 1武蓓 1王伊娜 1燕宇 1董葆 1蔡美顺 1左力1
作者信息
- 1. 北京大学人民医院肾内科,北京 100044
- 折叠
摘要
Abstract
Objective To explore the efficacy of low-dose and standard-dose Rituximab(RTX)for primary membranous nephropathy(PMN).Methods Patients with biopsy-proven PMN who received low-dose RTX and standard-dose RTX from January 2020 to June 2022 with follow-up in Peking University People's Hospital,were respectively enrolled.Clinical data and laboratory indices of these patients were collected.The patients were divided into low dose group and standard dose group according to the dosage of RTX.The differences in clinical indicators and remission rate between the two groups during baseline and follow-up were compared.The factors influencing dose selection of RTX and the risk factors of non-response to PMN treatment were discussed through multifactor analysis.Results Patients who received low dose RTX had a lower level of hemoglobin[(116.2±12.7)g/L vs.(132.6±16.2)g/L,P=0.014],and a higher level of creatinine[124.0(113.0,142.0)μmol/L vs.77.5(69.0,94.8)μmol/L,P=0.001]than patients received standard dose RTX.The overall effective rate is 67.4％,and there was no significant difference in the remission rate between the two groups(69.6％vs.65.0％,P=0.750).Multivariate logistic regression analysis showed that higher creatinine(OR 0.822,95％CI 0.684-0.987,P=0.036),lower hemoglobin(OR 1.821,95％CI 1.028-3.225,P=0.040)were the independent risk factors for low dose RTX selection,and proteinuria ≥8 g/24 h(OR 5.854,95％CI 1.247-27.482,P=0.025)was the independent risk factors of treatment no-remission.Conclusion The efficacy of low dose RTX is not inferior to that of standard dose RTX in the short term.For patients with anemia and renal dysfunction,doctors tend to choose low dose RTX to treat PMN.关键词
原发性膜性肾病/利妥昔单抗/低剂量/标准剂量/有效性Key words
primary membranous nephropathy/Rituximab/low dose/standard dose/efficacy分类
医药卫生引用本文复制引用
刘爱春,梁耀先,赵新菊,武蓓,王伊娜,燕宇,董葆,蔡美顺,左力..低剂量与标准剂量利妥昔单抗治疗原发性膜性肾病临床疗效分析[J].中国实用内科杂志,2024,44(1):59-63,5.
