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    杨武, 王小娥, 顾佳乐, 马丽娟, 苏白鸽, 肖慧捷, 姚勇, 张宏文. 宁夏地区利妥昔单抗治疗儿童原发性肾病综合征的开展及疗效分析[J]. 临床肾脏病杂志, 2024, 24(2): 103-107. DOI: 10.3969/j.issn.1671-2390.2024.02.003
    引用本文: 杨武, 王小娥, 顾佳乐, 马丽娟, 苏白鸽, 肖慧捷, 姚勇, 张宏文. 宁夏地区利妥昔单抗治疗儿童原发性肾病综合征的开展及疗效分析[J]. 临床肾脏病杂志, 2024, 24(2): 103-107. DOI: 10.3969/j.issn.1671-2390.2024.02.003
    Yang Wu, Wang Xiao-e, Gu Jia-le, Ma Li-juan, Su Bai-ge, Xiao Hui-jie, Yao Yong, Zhang Hong-wen. Application and efficacy analysis of rituximab in the treatment of childhood primary nephrotic syndrome in Ningxia[J]. Journal of Clinical Nephrology, 2024, 24(2): 103-107. DOI: 10.3969/j.issn.1671-2390.2024.02.003
    Citation: Yang Wu, Wang Xiao-e, Gu Jia-le, Ma Li-juan, Su Bai-ge, Xiao Hui-jie, Yao Yong, Zhang Hong-wen. Application and efficacy analysis of rituximab in the treatment of childhood primary nephrotic syndrome in Ningxia[J]. Journal of Clinical Nephrology, 2024, 24(2): 103-107. DOI: 10.3969/j.issn.1671-2390.2024.02.003

    宁夏地区利妥昔单抗治疗儿童原发性肾病综合征的开展及疗效分析

    Application and efficacy analysis of rituximab in the treatment of childhood primary nephrotic syndrome in Ningxia

    • 摘要:
      目的  利妥昔单抗(rituximab,RTX)目前已广泛用于儿童原发性肾病综合征(primary nephrotic syndrome,PNS)的治疗,特别是激素敏感频复发或激素依赖者,我们首次在宁夏地区开展了RTX治疗儿童PNS,并对其疗效进行了分析。
      方法  2020年1月1日至2022年12月31日北京大学第一医院宁夏妇女儿童医院收治的PNS患儿,经激素或激素联合免疫抑制剂治疗仍效果不满意者,包括频复发或激素依赖不能停药者,经家长同意后给予RTX治疗。定期监测患儿尿常规、尿蛋白定量、感染情况等,评估治疗其效果、安全性及治疗前后费用。
      结果  3年间,共7例PNS患儿应用RTX治疗,其中男4例、女3例,年龄范围4.4~13.0岁,均为激素敏感、频复发。随访9~35个月,RTX应用2~5剂每人次。所有患儿尿蛋白能长期维持阴性,其中仅复发1人次,激素和免疫抑制剂停药5人次,均未见严重感染。RTX治疗后平均每人每月花费较治疗前明显减少。
      结论  RTX是儿童PNS安全、经济、有效的治疗手段之一,建议尽早应用RTX以减停激素和/或免疫抑制剂,减少药物不良反应。

       

      Abstract:
      Objective Rituximab (RTX) has been widely used for primary nephrotic syndrome (PNS) in children of frequent relapse or hormonal dependence. The authors applied RTX for childhood PNS in Ningxia for the first time and examined its efficacy.
      Methods From January 1, 2020 to December 31, 2022, 7 PNS children received 3-year RTX dosing with parental consents after poor outcomes of glucocorticoids alone or glucocorticoids plus other immunosuppressants. There were 4 boys and 3 girls with an age range of (4.4-13.0) year. Urinary routine, urinary protein quantification and infection status were regularly monitored for evaluating the treatment effect, safety and expenses.
      Results All of them were hormonal sensitive with a frequent recurrence. Two to 5 doses of RTX per child were offered over a follow-up period of (9-35) month. Urinary protein stayed long-term negative. There was only 1 relapsing case. Five cases discontinued glucocorticoids and immunosuppressants. No severe infection occurred. The average monthly expense per child after RTX dosing was significantly lower than that before dosing.
      Conclusion RTX is a safe, economic and effective treatment for PNS children. Early application of RTX may taper glucocorticoids and/or immunosuppressants and minimize adverse reactions.

       

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