2026 年第 7 期 第 21 卷

狼疮性肾炎生物靶向治疗研究进展

Research progress on biological targeted therapy for lupus nephritis

作者：苏友格达古拉李鸿斌

英文作者：Suyouge Dagula Li Hongbin

单位：内蒙古医科大学附属医院风湿免疫科，呼和浩特010050

英文单位：Department of Rheumatology and Immunology the Affiliated Hospital of Inner Mongolia Medical University Hohhot 010050 China

关键词：狼疮性肾炎；系统性红斑狼疮；生物制剂；靶向治疗

英文关键词：Lupusnephritis;Systemiclupuserythematosus;Biologicalagents;Targetedtherapy

• 摘要：

• 狼疮性肾炎（LN）是系统性红斑狼疮最严重且最常见的终末器官表现，35%～60%的患者会出现肾脏受累，至少20%的LN患者会进展为慢性肾脏病。由于其复杂的发病机制，LN的治疗效果不尽人意，传统基于糖皮质激素和广谱免疫抑制剂的治疗方案存在应答不足、复发率高及长期毒性等问题。近年来，基于对LN免疫发病机制的深入理解，多种针对特定通路的新型生物制剂和小分子药物正处于后期研发阶段，在随机对照试验中，所有这些药物联合标准治疗方案在实现肾脏应答方面均优于单纯标准治疗，为LN治疗带来了新希望。本文系统综述了LN生物靶向治疗的最新进展。

• Lupus nephritis (LN) is the most severe and common end-organ manifestation of systemic lupus erythematosus. Renal involvement occurs in 35%-60% of patients, and at least 20% of patients with LN progress to chronic kidney disease. Due to its complex pathogenesis, the therapeutic effect of LN is unsatisfactory. Traditional treatment regimens based on glucocorticoids and broad-spectrum immunosuppressants have problems such as insufficient response, high recurrence rate and long-term toxicity. In recent years, based on the in-depth understanding of the immune pathogenesis of LN, a variety of novel biological agents and small-molecule drugs targeting specific pathways are in the late stage of research and development. In randomized controlled trials, all these drugs combined with standard treatment are superior to standard treatment alone in achieving renal response, bringing new hope for the treatment of LN. This article systematically reviews the latest progress in biological targeted therapy for LN.