利妥昔单抗治疗肾病综合征患者效果观察及对视黄醇结合蛋白、微循环状态的影响分析

摘要 目的：探讨与分析利妥昔单抗（RTX）治疗肾病综合征患者效果观察及对视黄醇结合蛋白（RBP）、微循环状态的影响。方法：2018年9月到2021年11月选择在本院诊治的肾病综合征患者66例作为研究对象，所有患者按入院先后顺序编号，依据治疗方法分为利妥昔单抗组和对照组各33例，对照组给予糖皮质激素治疗，利妥昔单抗组在对照组治疗的基础上给予利妥昔单抗治疗，治疗观察3个月，观察与检测血清RBP、微循环状态变化情况。结果：治疗后利妥昔单抗组的总有效率为97.0 %，明显高于对照组的81.8 %（P<0.05）。两组治疗后的尿蛋白定量、尿蛋白定性水平低于治疗前，利妥昔单抗组明显低于对照组，而血浆白蛋白较治疗前高，且利妥昔单抗组高于对照组（P<0.05）。两组治疗后的甲襞微循环管绊形态、流态评分明显低于治疗前，利妥昔单抗组明显低于对照组（P<0.05）。两组治疗后的血清RBP含量低于治疗前，利妥昔单抗组明显低于对照组（P<0.05）。两组治疗期间不良反应对比无明显差异（P>0.05）。结论：利妥昔单抗治疗肾病综合征患者能有效改善微循环状态，抑制血清RBP的表达，能提高治疗效果，还可促进改善肾功能，具有安全性。

Observation of the Effect of Rituximab in the Treatment of Patients with Nephrotic Syndrome and Analysis of Its Effect on Retinol Binding Protein and Microcirculation Status

ABSTRACT Objective: To explore and analysis the effects of Rituximab (RTX) in the treatment of patients with nephrotic syndrome and its effect on retinolbinding protein (RBP) and microcirculation state. Methods: From September 2018 to November 2021, 66 cases of patients with nephrotic syndrome who were diagnosed and treated in our hospital were selected as the research subjects. All patients were numbered according to the order of admission, and divided into rituximab group and matched group according to treatment methods, 33 patients in each group. The matched group were given glucocorticoid treatment, and the rituximab group were given rituximab treatment on the basis of the treatment of the matched group. The treatment were observed for 3 months, and the changes of serum RBP and microcirculation status were observed and detected. Results: After treatment, the total effective rates of the rituximab group were 97.0 %, which were higher than that of the matched group 81.8 %(P<0.05). The quantitative and qualitative levels of urinary protein in the two groups after treatment were lower than before, and the plasma albumin in the rituximab group was lower than that in the control group, while the plasma albumin in the rituximab group was higher than that in the matched group (P<0.05). After treatment, the nailfold microcirculation tube and flow state scores in the two groups were lower than those before treatment, and the rituximab group were lower than that in the matched group(P<0.05). The serum RBP levels in the two groups after treatment were lower than those before treatment, and the rituximab group were lower than that in the matched group(P<0.05). The adverse reactions during the two groups were no difference compared between the two groups(P>0.05). Conclusion: Rituximab in the treatment of patients with nephrotic syndrome can effectively improve the microcirculation state, inhibit the expression of serum RBP, improve the therapeutic effect, and improve the renal function of patients, and has good safety.