【摘要】 目的:评价利妥昔单抗治疗成人微小病变肾病(minimal change disease, MCD)的疗效及安全性。方法:本研究为单中心回顾性研究，选取深圳市第二人民医院肾内科自2020年1月1日—2022年12月31日收治经利妥昔单抗(rituximab, RTX)治疗的成人MCD患者，入选者经RTX 1 000 mg, 2次，2次用药间隔2周的治疗，收集患者的临床资料和实验室检查。随访的主要观察指标为肾病的缓解和复发情况，并采用广义相加混合模型分析6个月完全缓解患者与未完全缓解患者尿蛋白下降速度及血清白蛋白上升速度的差异。结果:共纳入25例患者，男17例，在接受RTX治疗后，25例完成了6个月随访，缓解(CR+PR)率88%,完全缓解率为72%,完全缓解中位时间4个月；未缓解率12%。13例完成了12个月随访，缓解(CR+PR)率为96%,完全缓解率为84%,未缓解率4%。在取得完全缓解后平均随访时间(13.25±6.47)月，1例患者在使用RTX取得完全缓解后10个月出现复发，追加1 g RTX 1个月后再次取得完全缓解，余均未出现复发。尿蛋白下降速度快和血清白蛋白上升快的患者，更容易获得完全缓解。结论:RTX用于治疗成人MCD能有效诱导患者达到临床完全缓解或部分缓解，短期复发率低，治疗效果良好且安全性高，将可能成为有激素使用限制的成人MCD患者治疗新选择。更多还原

【Abstract】 Objective:To evaluate the efficacy and safety of rituximab(RTX) in the treatment of minimal change disease(MCD) in adults. Methods:It was a single-center retrospective study conducted at the Department of Nephrology, Shenzhen Second People’s Hospital. Adult MCD patients who received rituximab treatment from January 1, 2020, to December 31, 2022, were included. The selected patients received RTX at a dose of 1 000 mg twice, with a 2-week interval between doses. Clinical data and laboratory examinations were collected. The main observation indicators were remission and relapse of kidney disease. The differences in the rate of urinary protein reduction and serum albumin increase between patients achieving complete remission and those who did not were analyzed using generalized additive mixed models. Results:There were 25 patients included in this study, 17 males. After RTX treatment, 25 patients completed the 6-month follow-up, with a remission(CR+PR) rate of 88% and a complete remission rate of 72%. The median time to acheive complete remission was 4 months. The non-remission rate was 12%. 13 patients completed the 12-month follow-up, with a remission(CR+PR) rate of 96%, a complete remission rate of 84%, and a non-remission rate of 4%. In the mean follow-up time of(13.25±6.47) months after achieving complete remission, one patient experienced a relapse 10 months after achieving complete remission with RTX, and then abtained complete remission again 1 month after adding 1 g of RTX, and the rest did not experience any relapse. Patients with a faster rate of urinary protein reduction and serum albumin increase were more likely to achieve complete remission. Conclusion:Rituximab treatment effectively induces complete or partial clinical remission in adult MCD patients. It has a low short-term relapse rate and demonstrates good efficacy and safety. Therefore, rituximab can be considered as a new treatment option for adult MCD patients.更多还原