摘要
目的:总结肾移植术后局灶节段性肾小球硬化(FSGS)复发的诊断、治疗及转归;探讨循环渗透因子组风险等级评估对FSGS复发的预测价值。方法:总结2例肾移植术后FSGS复发受者的术前及术后临床病史、肾穿刺活检病理、循环渗透因子组风险等级评估、治疗方法及效果;分析循环渗透因子组风险等级评估与FSGS复发之间的关系。结果:2例受者原发病均为原发性FSGS,24 h尿蛋白定量超过10 g,经移植肾活检确诊FSGS复发,术前的循环渗透因子组风险等级评估均为高风险。经过血浆置换联合利妥昔单抗,辅以雷公藤多甙治疗后,24 h尿蛋白定量明显下降,全身水肿减轻,肾功能稳定。结论:肾移植术后复发FSGS经血浆置换联合利妥昔单抗治疗可以有效缓解症状;循环渗透因子组风险等级评估对预测FSGS复发风险可能有参考价值。
Objective To summarize the diagnosis,treatment and outcome of recurrent focal segmental glomurular sclerosis(FSGS)after kidney transplantation and explore the predictive value of risk grade assessment of peripheral circulating permeability factor for recurrent FSGS.Methods Retrospective analysis was performed for pathological history,biopsy finding before and after transplantation,blood level of FSGS biomarkers of two patients with recurrent FSGS.Then the relationship was analyzed between the risk grade assessment of peripheral circulating permeability factor and recurrent FSGS.Results Both patients belonged to primary FSGS with>10g/24h urine protein.The recurrence of FSGS after transplantation was confirmed by renal biopsy.After plasma exchange,rituximab and Tripterygium wilfordii,24-hour urine protein content declined,general edema subsided significantly and renal function stabilized.Conclusions After renal transplantation,plasma exchange and rituximab can effectively alleviate the symptoms of recurrent FSGS.And assessing risk level of peripheral circulating permeability factor panel may have value in predicting the recurrent risk of FSGS.
作者
李敛
涂亚芳
廖雯靚
王娟
吴雄飞
Li Lian;Tu Yafang;Liao Wenliang;Wang Juan;Wu Xiongfei(Center of Nephrology,Dialysis&Transplantation,Renmin Hospital,Wuhan University,Wuhan 430060,China)
出处
《中华器官移植杂志》
CAS
北大核心
2020年第2期75-78,共4页
Chinese Journal of Organ Transplantation
关键词
肾移植
局灶节段性肾小球硬化
复发
循环渗透因子
风险等级
Kidney transplantation
Focal segmental glomerulosclerosis
Recurrent
Circulating permeating factor
Risk grade
