摘要
目的:探讨利妥昔单抗(RTX)治疗儿童激素敏感型肾病综合征的疗效及安全性。方法:选取2022年1月—2023年12月福州市第一总医院儿童专科院区收治的40例儿童激素敏感型肾病综合征患儿,随机分为对照组与观察组,各20例。对照组使用糖皮质激素进行治疗,观察组在进行糖皮质激素治疗后加用RTX。两组均随访12个月,比较尿蛋白转阴时间、病情年复发率、激素年累计用量、年感染次数、库欣面容、激素性青光眼发生情况、年身高增加幅度及骨强度降低发生情况。结果:观察组患儿尿蛋白转阴时间短于对照组,病情年复发次数少于对照组,激素年累计用量少于对照组,差异显著(P<0.05)。治疗后,观察组患儿年感染次数少于对照组,库欣面容及激素性青光眼发生率均低于对照组,差异显著(P<0.05)。观察组患儿年身高增加幅度大于对照组,骨强度降低发生率低于对照组,差异显著(P<0.05)。结论:RTX治疗儿童激素敏感型肾病综合征可加速尿蛋白转阴,降低病情复发率、库欣面容与激素性青光眼发生率,减少激素累计用量与感染次数,对身高与骨密度的影响也较小。
Objective:To investigate the efficacy and safety of rituximab(RTX)in the treatment of steroid-sensitive nephrotic syndrome(SSNS)in children.Methods:Forty children with SSNS admitted to the Children's Specialized Campus of Fuzhou First General Hospital from January 2022 and December 2023 were selected and randomly divided into a control group and an observation group,with 20 cases in each group.The control group was treated with glucocorticoids,while the observation group received RTX in addition to glucocorticoid therapy.Both groups were followed up for 12 months.The time to urine protein turning negative,annual relapse rate,cumulative glucocorticoid dosage,annual number of infections,incidence of Cushingoid facies and steroid-induced glaucoma,annual height increase,and incidence of reduced bone strength were compared between the two groups.Results:The time to urine protein turning negative in the observation group was shorter than that in the control group,the annual relapse rate was lower than that in the control group,and the cumulative glucocorticoid dosage was less than that in the control group,the differences being significant(P<0.05).After treatment,the annual number of infections in the observation group was fewer than that in the control group,and the incidences of Cushingoid facies and steroid-induced glaucoma were lower than those in the control group,the differences being significant(P<0.05).The annual height increase in the observation group was greater than that in the control group,and the incidence of reduced bone strength was lower than that in the control group,the differences being significant(P<0.05).Conclusion:Rituximab in the treatment of childhood SSNS can accelerate the disappearance of urine protein,reduce the relapse rate and the incidence of Cushingoid facies and steroid-induced glaucoma,decrease the cumulative glucocorticoid dosage and the number of infections,and has less impact on height and bone density.
作者
庄宇
张美红
王璐
ZHUANG Yu;ZHANG Meihong;WANG Lu(Department of Nephrology,Childrens Specialized Campus,Fuzhou First General Hospital,Fuzhou 350004,China)
出处
《延边大学医学学报》
2025年第12期28-31,共4页
Journal of Medical Science Yanbian University
