糖皮质激素联合利妥昔单抗对特发性膜性肾病患者血脂、 Th17/Treg 失衡和血清 PLA2R 抗体、THSD7A 抗体的影响.

To investigate the effects of glucocorticoid combined with rituximab on blood lipids, helper T cell 17 (Th17)/regulatory T cell (Treg) imbalance, serum anti-phospholipase A2 receptor (PLA2R) antibody and anti-type I thrombospondin 7A domain (THSD7A) antibody in patients with idiopathic membranous nephropathy (IMN). 112 IMN patients who were admitted to Tangdu Hospital of Air Force Military Medical University from March of 2022 to March 2023 were collected. Enrolled patients were divided into control group (56 cases, glucocorticoid treatment) and treatment group (56 cases, rituximab treatment on the basis of control group) according to the random number table method. The efficacy, blood lipids [low density lipoprotein cholesterol (LDL-C), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), triglyceride (TG)], renal function [cystatin C (CysC), serum creatinine (Scr), blood urea nitrogen (BUN), 24 hour urine total protein quanti-fication], Th17/Treg related indicators [Th17 cell percentage, interleukin-17 (IL-17), Treg cell percentage, transforming growth factor β1 (TGF-β1), tumor necrosis factor-α (TNF-α)], serum PLA2R antibody and THSD7A antibody levels were observed in two groups, and the safety in two groups was observed. Compared with control group, the total clinical effective rate in treatment group was higher (P<0.05). Compared with control group, TC, TG, LDL-C, CysC, Scr, BUN, 24 hour urine total protein quanti-fication, Th17, IL-17, TNF-α, PLA2R antibody, THSD7A antibody were lower in treatment group 6 months after treatment, and HDL-C, Treg and TGF-β1 were higher (P<0.05). There was no difference in the incidence of adverse reactions between two groups (P>0.05). Glucocorticoid combined with rituximab in patients with IMN can effectively improve blood lipids, Th17 / Treg imbalance, serum PLA2R antibody and THSD7A antibody levels, without increasing the incidence of adverse reactions, and has good clinical application value. [ABSTRACT FROM AUTHOR]