| 摘要: |
| ［摘要］ 目的 分析利妥昔单抗（RTX）治疗成人难治性原发性局灶节段性肾小球硬化症（FSGS）的疗效及安全性。方法 回顾性分析2021年1月1日至2025年7月31日于广西壮族自治区人民医院肾内科接受RTX治疗的成人难治性原发性FSGS 14例的临床资料，数据来源于院内电子病历系统及随访记录。结果 病理分型非特殊型12例，顶端型2例。患者首次接受RTX治疗的中位年龄为37.5（23.0，69.5）岁。9例采用单剂疗法，5例采用2剂疗法，所有患者均完成定期随访。随访6个月时，9例患者达到完全缓解，5例达到部分缓解。3例激素抵抗型FSGS患者在RTX治疗第6个月时均获得完全缓解。3例超重及1例肥胖患者采用单剂RTX方法，在治疗后6个月时均能达到完全缓解。随访过程中所有患者均未出现药物相关不良反应。结论 单剂RTX不仅对成人激素依赖型、频繁复发型FSGS有效，且同样适用于激素抵抗型FSGS。单剂RTX对超重及肥胖患者的疗效与正常体质量及偏瘦患者或许无明显差异。RTX治疗后需密切随访，注意预防感染。 |
| 关键词: 利妥昔单抗 局灶节段性肾小球硬化症 难治性 成人 疗效 |
| DOI：10.3969/j.issn.1674-3806.2025.12.06 |
| 分类号:R 692 |
| 基金项目:广西重点研发计划项目（编号：桂科AB24010219）；广西医疗卫生适宜技术开发与推广应用项目（编号：S2020069） |
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| Analysis on the efficacy and safety of rituximab in treatment of refractory primary focal segmental glomerulosclerosis in adults |
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GUAN Lisi1,2, YE Kun2,3, WEI Qiaoyu2,3, DENG Meiqiu2,3, HUANG Shaorong1,2
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1.Graduate School, Guangxi Medical University, Nanning 530021, China; 2.Department of Nephrology, the People′s Hospital of Guangxi Zhuang Autonomous Region(Guangxi Academy of Medical Sciences), Nanning 530021, China; 3.Guangxi Clinical Research Center for Chronic Kidney Diseases, Nanning 530021, China
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| Abstract: |
| ［Abstract］ Objective To analyze the efficacy and safety of rituximab(RTX) in treatment of refractory primary focal segmental glomerulosclerosis(FSGS) in adults. Methods The clinical data of 14 adult patients who were diagnosed with refractory primary FSGS and received RTX treatment in Department of Nephrology, the People′s Hospital of Guangxi Zhuang Autonomous Region from January 1, 2021 to July 31, 2025 were retrospectively analyzed. These data were sourced from the electronic medical record system of the People′s Hospital of Guangxi Zhuang Autonomous Region and the follow-up records of the patients. Results The pathological types included 12 cases of non-specific type and 2 cases of apical type. The median age of the patients receiving RTX treatment for the first time was 37.5(23.0, 69.5)years. Nine patients received single-dose treatment and 5 patients received 2-dose treatment, and the regular follow-up was completed in all the patients. At the 6-month follow-up, 9 patients achieved complete remission and 5 patients achieved partial remission. Three FSGS patients with steroid-resistant type achieved complete remission at the sixth month of RTX treatment. Three overweight patients and one obese patient were treated with a single dose of RTX and all of them achieved complete remission 6 months after RTX treatment. During the follow-up period, all the patients did not experience any drug-related adverse reactions. Conclusion A single dose of RTX is not only effective for adult patients with steroid-dependent type and frequently relapsing type of FSGS, but also applicable to steroid-resistant type of FSGS. The therapeutic response to a single dose of RTX in overweight and obese patients may not be significantly different from that in normal-weight and underweight patients. After RTX treatment, the patients need to be closely followed up and attention should be paid to preventing infection in them. |
| Key words: Rituximab(RTX) Focal segmental glomerulosclerosis(FSGS) Refractory Adults Efficacy |
