摘要
Abstract
Objective:To investigate the efficacy of dapagliflozin combined with rituximab in the treatment of anti-phospholipase A2 receptor(PLA2R)antibody-positive membranous nephropathy(MN)and its effect on helper T cells(Th17)/regulatory T cells(Treg).Methods:A total of 80 patients with PLA2R antibody positive-MN treated in the Department of Nephrology at a hospital between April 2020 and July 2024 were retrospectively selected and assigned to the observation group and control group based on medication regimens,with 40 patients in each group.Both groups were treated with angiotensin converting enzyme inhibitors/angiotensin receptor blockers.On this basis,the control group was treated with rituximab,and the observation group was treated with dapagliflozin combined with rituximab.Renal function parameters[24 h urinary total protein(24 h UTP),serum creatinine(Scr),blood urea nitrogen(BUN)],Th17/Treg,kidney injury markers[kidney injury molecule-1(KIM-1),cystatin C(CysC),β2-microglobulin(β2-MG),soluble growth stimulation expressed gene 2(sST2)],clinical response rate,PLA2R,adverse reactions and recurrence rate were compared between the two groups.Results:After treatment,the levels of 24 h UTP,Scr,BUN,Th17,KIM-1,CysC,β2-MG,sST2 and PLA2R antibodies in the two groups were decreased,with the observation group showing lower levels than the control group.The levels of Treg and Th17/Treg were increased,with the observation group showing higher levels than the control group(P<0.05).The clinical response rate in the observation group(87.50%)was higher than that in the control group(75.00%),with no statistically significant difference observed(P>0.05).No statistically significant differences in the incidence of adverse reactions and recurrence rate were observed between the two groups(P>0.05).Conclusion:Dapagliflozin combined with rituximab in the treatment of patients with PLA2R antibody-positive MN can effectively improve renal function,regulate Th17/Treg balance and reduce renal injury,with a favorable safety profile.关键词
膜性肾病/抗磷脂酶A2 受体抗体/达格列净/利妥昔单抗/肾功能/生存质量Key words
membranous nephropathy/anti-phospholipase A2 receptor antibody/dapagliflozin/rituximab/renal function/quality of life分类
医药卫生
