协和医学杂志2026，Vol.17Issue(2)：301-309,9.DOI:10.12290/xhyxzz.2026-0183
原发性膜性肾病的免疫抑制治疗
Immunosuppressive Therapy for Primary Membranous Nephropathy
李超 1李学旺1
作者信息
- 1. 中国医学科学院北京协和医学院,北京协和医院肾内科,北京 100730
- 折叠
摘要
Abstract
Primary membranous nephropathy(PMN)is a leading cause of nephrotic syndrome in adults.The discovery of antibodies against phospholipase A2 receptor(PLA2R)has ushered in the era of biomarker-based diagnosis and therapeutic monitoring for PMN.The cornerstone of immunosuppressive therapy lies in risk stratification based on proteinuria levels,renal function,and dynamic changes in anti-PLA2R antibody titers,enabling individualized timing of treatment initiation with the dual goals of achieving both immunological and clinical remission.This article systematically reviews the initiation timing,first-line therapeutic options—inclu-ding cyclophosphamide combined with corticosteroids,calcineurin inhibitors,and anti-CD20 monoclonal anti-bodies—and key considerations for follow-up and relapse management in PMN,integrating evidence-based find-ings with clinical practice to inform individualized decision-making.关键词
原发性膜性肾病/抗磷脂酶A2 受体抗体/免疫抑制治疗/环磷酰胺/利妥昔单抗Key words
primary membranous nephropathy/phospholipase A2 receptor antibody/immunosuppressive therapy/cyclo-phosphamide/Rituximab分类
医药卫生引用本文复制引用
李超,李学旺..原发性膜性肾病的免疫抑制治疗[J].协和医学杂志,2026,17(2):301-309,9.
