标题：难治性特发性膜性肾病诊治进展

      作者：刘纹 综述 许勇芝 审校    广东医科大学附属医院肾脏疾病研究所，广东 湛江 524000

      卷次： 2021年32卷4期

      【摘要】 膜性肾病是肾病综合征的病理类型之一，在成人中最常见，按病因可分为特发性膜性肾病(IMN)和继发性膜性肾病(SNM)两类。研究表明，在给予特发性膜性肾病患者激素联合免疫抑制治疗的情况下，多数患者疗效较好，但仍有30%的 IMN患者表现为持续性NS，被称为难治性 IMN (RIMN)。目前国内外对于RIMN患者治疗的研究仍处于探索阶段，如何早期识别难治性特发性膜性肾病，如何制定个体化的治疗方案，是临床工作中棘手的问题之一。本文就RIMN的早期识别及治疗进展作一综述，旨在提高RIMN的临床疗效，改善患者预后。
      【关键词】 难治性特发性膜性肾病；利妥昔单抗；多靶点治疗；早期识别；治疗进展
      【中图分类号】 R692 【文献标识码】 A 【文章编号】 1003—6350（2021）04—0511—05

Progress in diagnosis and treatment of refractory idiopathic membranous nephropathy.
LIU Wen, XU Yong-zhi.Institute of Nephrology, Affiliated Hospital of Guangdong Medical University, Zhanjiang 524000, Guangdong, CHINA【Abstract】 Membranous nephropathy is one of the pathological types of nephrotic syndrome, it is the most com-mon in adults. According to the cause, it can be divided into idiopathic membranous nephropathy (IMN) and secondarymembranous nephropathy (SNM). Studies have shown that treated by hormones combined with immunosuppressive ther-apy, most patients with idiopathic membranous nephropathy have better curative effects, however, 30% of IMN patientsstill have persistent NS, which is called refractory IMN. At present, researches on the treatment of RIMN patients athome and abroad are still in the exploratory stage. How to identify refractory idiopathic membranous nephropathy(RIMN) early, and how to develop an individualized treatment plan is still one of the thorny issues in clinical work. Thisarticle reviews the progress of early recognition and treatment of RIMN, aiming to improve the clinical efficacy ofRIMN and improve the prognosis of patients.
      【Key words】 Refractory idiopathic membranous nephropathy (RIMN); Rituximab; Multi-target therapy; Earlyrecognition; Treatment progress·综述·doi:10.3969/j.issn.1003-6350.2021.04.028