Observation on the effect of Cyclophosphamide combined with Rituximab in the treatment of refractory nephrotic syndrome in children
XIA Wei
Department of Pediatric Nephrology,BenQ Medical Center,the Affiliated BenQ Hospital of Nanjing Medical University,Jiangsu Province,Nanjing 210000,China
Abstract：Objective To investigate the clinical effect of Cyclophosphamide combined with Rituximab in the treatment of refractory nephrotic syndrome in children.Methods A total of 98 children with refractory nephrotic syndrome who were treated in the Affiliated BenQ Hospital of Nanjing Medical University from July 2019 to July 2021 were selected as the research objects.They were divided into control group (n=49) and combination group (n=49) by random number table method.The control group was treated with glucocorticoid+Tacrolimus+Cyclophosphamide,while the combination group were treated with Rituximab on the basis of the control group.After treatment,the clinical efficacy of the two groups was evaluated,the renal function and immune function of the two groups were compared before treatment and 1 month after treatment,and the adverse reactions of the two groups were compared.Results The total effective rate of the combination group was 95.92%,which was higher than 81.63%of the control group,and the difference was statistically significant (P＜0.05).After 1 month of treatment,the levels of serum creatinine (SCr),blood urea nitrogen (BUN),urinary protein and β2-microglobulin (β2-MC)in the two groups were lower than those before treatment,and the differences were statistically significant (P＜0.05).After 1 month of treatment,the levels of SCr,BUN,urine protein and β2-MC in the combination group were lower than those in the control group,and the differences were statistically significant (P＜0.05).The levels of CD20+B in the two groups after 1 month of treatment were lower than those before treatment,and the difference was statistically significant (P＜0.05),and the level of CD20+B in the combination group after 1 month of treatment was lower than that in the control group,and the difference was statistically significant (P＜0.05).There was no significant difference in the total incidence of adverse reactions between the two groups (P ＞0.05).Conclusion Clinical application of Cyclophosphamide combined with Rituximab in the treatment of children with refractory nephrotic syndrome can obtain better clinical efficacy,can effectively improve the level of renal function and immune function of children,and is helpful to the prognosis of children,without significantly increasing adverse reactions,which has clinical reference value.
夏伟. 环磷酰胺联合利妥昔单抗治疗儿童难治性肾病综合征的效果观察[J]. 中国当代医药, 2023, 30(21): 71-75.
XIA Wei. Observation on the effect of Cyclophosphamide combined with Rituximab in the treatment of refractory nephrotic syndrome in children. 中国当代医药, 2023, 30(21): 71-75.
Ishimori S，Ando T，Kikunaga K.Influenza virus vaccination in pediatric nephrotic syndrome significantly reduces rate of relapse and influenza virus infection as assessed in a nationwide survey[J].Sci Rep，2021，11（1）：23305.
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