Article(id=1211269165172781698, tenantId=1146029695717560320, journalId=1189873630562394117, issueId=1211269157790806494, articleNumber=null, orderNo=null, doi=10.11855/j.issn.0577-7402.2021.04.10, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=research-article, receivedDate=1609862400000, receivedDateStr=2021-01-06, revisedDate=1614960000000, revisedDateStr=2021-03-06, acceptedDate=null, acceptedDateStr=null, onlineDate=1766718673270, onlineDateStr=2025-12-26, pubDate=1619539200000, pubDateStr=2021-04-28, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1766718673270, onlineIssueDateStr=2025-12-26, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1766718673270, creator=13701087609, updateTime=1766718673270, updator=13701087609, issue=Issue{id=1211269157790806494, tenantId=1146029695717560320, journalId=1189873630562394117, year='2021', volume='46', issue='4', pageStart='319', pageEnd='424', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=0, createTime=1766718671510, creator=13701087609, updateTime=1766718756000, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1211269512217882745, tenantId=1146029695717560320, journalId=1189873630562394117, issueId=1211269157790806494, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1211269512217882746, tenantId=1146029695717560320, journalId=1189873630562394117, issueId=1211269157790806494, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=380, endPage=385, ext={EN=ArticleExt(id=1211269166879863451, articleId=1211269165172781698, tenantId=1146029695717560320, journalId=1189873630562394117, language=EN, title=Application of rituximab in treating six patients with chronic periaortitis and literature review, columnId=1190310109000602400, journalTitle=Medical Journal of Chinese People’s Liberation Army, columnName=Clinical Research, runingTitle=null, highlight=null, articleAbstract=
Objective By literature review to retrospectively study the clinical characteristics, diagnosis and treatment process and prognosis of chronic periaortitis (CP) treated with rituximab (RTX), and to improve the understanding of it. Methods To retrospectively analyze the clinical characteristics, laboratory indicators, changes of imaging findings and adverse reactions before and after RTX treatment of six CP patients admitted in the First Medical Center of Chinese PLA General Hospital from October 2014 to November 2020. The clinical remission was defined as the disappearance of clinical symptoms and hydronephrosis, erythrocyte sedimentation rate (ESR) <15 mm/h and C-reactive protein (CRP) <5 mg/L; complete remission was defined as the clinical remission and the maximum transverse diameter of retroperitoneal mass reduced by 50%. Fifty-eight similar cases were collected by searching the database to investigate the efficacy and safety of RTX in treating patients with CP. Results All the 6 patients were males, aged 49.5 (42.0-62.0) years, with pathogenesis of 60 (30-365) days and mean follow-up time of 25.7 (0.9-66.9)months. Three of the 6 patients had severe cardiovascular disease in the past, one suffered from thoracic aorta involvement. RTX alone was given in 3 patients, and together with prednisone in 3 other patients as induce remission therapy, respectively. Five patients achieved clinical remission, of them one was given small dose of prednisone to maintain long-term remission, the other 4 patients received regular application of RTX to maintain remission. The median remission time was 4.0 (0.5-6.0) months. Three patients got complete remission with the median remission time of 18 months (16-24). No recurrence was observed during follow-up. None of the 6 patients had an infusion-related response. One had pulmonary infection at the 3.5-month after the RTX application. A total of 58 cases were found in literature. Clinical symptoms, laboratory tests and imaging findings were all improved. Five (8.6%) patients were infected, 1 (1.7%) was died and 3 (5.2%) had a recurrence after the treatment of RTX. Conclusion Rituximab is an effective and safe regimen in inducing and maintaining remission for chronic periaortitis patients.
, correspAuthors=Jian Zhu, authorNote=null, correspAuthorsNote=
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目的 报道6例经利妥昔单抗(RTX)治疗的慢性主动脉周围炎(CP)患者的临床特点、诊治经过及预后并进行文献复习，以提高对该病的认识。方法 回顾性分析解放军总医院第一医学中心2014年10月—2020年11月收治的6例CP患者应用RTX治疗前后的临床症状、实验室指标、影像学表现变化及不良反应。临床缓解定义为临床症状消失、肾盂积水消失、红细胞沉降率<15 mm/h、C反应蛋白<5 mg/L；完全缓解定义为临床缓解及影像学提示腹膜后包块最大横径缩小50%。检索相关数据库，结合文献报道的58例患者，总结RTX治疗CP的有效性及安全性。结果 6例患者均为男性，年龄49.5(42.0~62.0)岁，病程60(30~365) d，随访时间25.7(0.9~66.9)个月。其中3例既往合并严重心血管疾病、1例合并胸主动脉受累。3例应用泼尼松0.25~0.5 mg/(kg·d)联合RTX作为诱导缓解方案，其余3例单用RTX诱导缓解。5例达到临床缓解，其中4例规律应用RTX维持缓解，1例应用小剂量泼尼松维持，中位缓解时间为4.0(0.5~6.0)个月；3例达到完全缓解，中位缓解时间为18(16~24)个月；6例均未出现疾病复发。6例患者未出现输注反应，1例在应用RTX后的第3.5个月出现肺部感染。国内外报道RTX治疗CP共58例，治疗后患者临床症状、实验室指标及影像学表现均有改善，应用RTX后仅5例(8.6%)出现感染，1例(1.7%)死亡，3例(5.2%)复发。结论 应用RTX作为诱导缓解及维持缓解方案治疗CP临床效果好，且安全性较高。
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廖思敏，博士研究生，主要从事腹膜后纤维化与IgG4相关性疾病方面的研究
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2018,
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Imaging data of a patient with thoracic aorta and abdominal aorta involvement, figureFileSmall=E9h3Wg93IF+uIEU6aRlcYg==, figureFileBig=P3TGUfbKdCaD2LAKOVsiyQ==, tableContent=null), ArticleFig(id=1211269172760277945, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1211269165172781698, language=CN, label=图1, caption=
1例胸主动脉联合腹主动脉受累患者影像学资料CT. 电子计算机断层扫描；MIP. CT最大密度投影；PET-CT. 正电子发射计算机断层成像；箭头示周围有软组织代谢伴摄取增高。
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Baseline demographic data and clinical features of the six CP patients
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| 患者编号 | 性别 | 年龄(岁) | 病程(d) | 随访时间(月) | 既往疾病 | 临床症状 | 肾盂积水 | 血清IgG4(mg/dl) | 病理 | 受累部位 |
|---|
| 1 | 男 | 42 | 210 | 41.6 | 高血压病、风湿性心脏病、房颤、心功能不全 | 腹痛、腰痛、背痛 | 有 | 149 | 未做 | 腹主动脉旁、两侧髂总动脉旁 |
| 2 | 男 | 51 | 60 | 22.8 | 高血压病 | 腰痛、睾丸疼痛 | 无 | 89.7 | 非IgG4相关性CP | 腹主动脉旁 |
| 3 | 男 | 62 | 40 | 0.9 | 冠心病、陈旧性心肌梗死、2型糖尿病 | 腹痛、腰痛、发热 | 无 | 158 | 未做 | 腹主动脉旁、右侧髂总动脉旁 |
| 4 | 男 | 55 | 60 | 66.9 | 陈旧性肺结核 | 无 | 有 | 45.2 | IgG4-CP | 腹主动脉旁、左侧肾门 |
| 5 | 男 | 48 | 30 | 1.2 | 高血压病、冠心病 | 腹痛 | 有 | 274 | IgG4-CP | 腹主动脉旁 |
| 6 | 男 | 42 | 365 | 28.7 | 无 | 背痛、发热 | 无 | 57.7 | 未做 | 胸主动脉旁、腹主动脉旁 |
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6例慢性主动脉周围炎患者基线期一般资料
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| 患者编号 | 性别 | 年龄(岁) | 病程(d) | 随访时间(月) | 既往疾病 | 临床症状 | 肾盂积水 | 血清IgG4(mg/dl) | 病理 | 受累部位 |
|---|
| 1 | 男 | 42 | 210 | 41.6 | 高血压病、风湿性心脏病、房颤、心功能不全 | 腹痛、腰痛、背痛 | 有 | 149 | 未做 | 腹主动脉旁、两侧髂总动脉旁 |
| 2 | 男 | 51 | 60 | 22.8 | 高血压病 | 腰痛、睾丸疼痛 | 无 | 89.7 | 非IgG4相关性CP | 腹主动脉旁 |
| 3 | 男 | 62 | 40 | 0.9 | 冠心病、陈旧性心肌梗死、2型糖尿病 | 腹痛、腰痛、发热 | 无 | 158 | 未做 | 腹主动脉旁、右侧髂总动脉旁 |
| 4 | 男 | 55 | 60 | 66.9 | 陈旧性肺结核 | 无 | 有 | 45.2 | IgG4-CP | 腹主动脉旁、左侧肾门 |
| 5 | 男 | 48 | 30 | 1.2 | 高血压病、冠心病 | 腹痛 | 有 | 274 | IgG4-CP | 腹主动脉旁 |
| 6 | 男 | 42 | 365 | 28.7 | 无 | 背痛、发热 | 无 | 57.7 | 未做 | 胸主动脉旁、腹主动脉旁 |
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The treatment and outcomes of six CP patients
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| 患者编号 | 既往治疗 | RTX治疗 | 临床缓解/完全缓解 |
|---|
| 1 | / | 激素+RTX(第0周、第2周) | 完全缓解 |
| 2 | 激素+CTX+HCQ | RTX(第0周、第2周) | 临床缓解 |
| 3 | / | RTX(第0周、第2周、第6个月) | 临床缓解 |
| 4 | 手术+MMF+HCQ | RTX(第0周、第2周、第6个月、第12个月、第18个月、第24个月、第30个月、第36个月、第42个月、第54个月) | 完全缓解 |
| 5 | / | 激素+RTX(第0周、第2周) | – |
| 6 | / | 激素+RTX(第0周、第2周、第6个月、第12个月、第24个月) | 完全缓解 |
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6例慢性主动脉周围炎患者治疗及缓解情况
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| 患者编号 | 既往治疗 | RTX治疗 | 临床缓解/完全缓解 |
|---|
| 1 | / | 激素+RTX(第0周、第2周) | 完全缓解 |
| 2 | 激素+CTX+HCQ | RTX(第0周、第2周) | 临床缓解 |
| 3 | / | RTX(第0周、第2周、第6个月) | 临床缓解 |
| 4 | 手术+MMF+HCQ | RTX(第0周、第2周、第6个月、第12个月、第18个月、第24个月、第30个月、第36个月、第42个月、第54个月) | 完全缓解 |
| 5 | / | 激素+RTX(第0周、第2周) | – |
| 6 | / | 激素+RTX(第0周、第2周、第6个月、第12个月、第24个月) | 完全缓解 |
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Rituximab for treatment of chronic periaortitis reported in previous literature
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| 发表文献 | 例数 | 男/女(例) | 平均年龄(岁) | 随访时间(月) | 受累部位 | 治疗方案 | 预后 |
|---|
| Dedinská等[9] | 1 | 1/0 | 45 | / | 腹主动脉旁 | 375 mg/(m2·周)RTX×4周，激素联合吗替麦考酚酯维持 | 肌酐由180 μmol/L降至110 μmol/L，肿物缩小 |
| Almeqdadi等[10] | 1 | 0/1 | 64 | 5.25 | 腹主动脉旁 | 40 mg/d泼尼松×4周，第5周起375 mg/(m2·周)RTX×4周 | 21周达临床缓解 |
| Urban等[17] | 20 | / | / | 17-61 | 主动脉旁、髂动脉旁 | 4例单用RTX[1 g/2周或375 mg/(m2·周)×4周]治疗，16例泼尼松联合RTX(方案如上) | 75%(15/20)达临床缓解；3例复发；1例死亡；1例并发慢性淋巴细胞白血病 |
| Boyeva等[18] | 10 | 8/2 | 58.5 | / | / | RTX 1 g/2周×2次 | 肌酐、C反应蛋白下降；2例感染 |
| Wallwork等[19] | 26 | 22/4 | 55 | 2.8-4.2 | 主动脉旁、髂动脉旁 | 19例单用RTX 1 g/2周×2次；7例泼尼松联合RTX(方案如上) | 88%(22/25)影像学肿块缩小10%；100%(19/19)症状消失；25%(4/16)红细胞沉降率降至正常；20%(2/10)C反应蛋白降至正常；3例感染 |
), ArticleFig(id=1211269173326509012, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1211269165172781698, language=CN, label=表3, caption=
既往文献报道的利妥昔单抗(RTX)治疗慢性主动脉周围炎的情况
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| 发表文献 | 例数 | 男/女(例) | 平均年龄(岁) | 随访时间(月) | 受累部位 | 治疗方案 | 预后 |
|---|
| Dedinská等[9] | 1 | 1/0 | 45 | / | 腹主动脉旁 | 375 mg/(m2·周)RTX×4周，激素联合吗替麦考酚酯维持 | 肌酐由180 μmol/L降至110 μmol/L，肿物缩小 |
| Almeqdadi等[10] | 1 | 0/1 | 64 | 5.25 | 腹主动脉旁 | 40 mg/d泼尼松×4周，第5周起375 mg/(m2·周)RTX×4周 | 21周达临床缓解 |
| Urban等[17] | 20 | / | / | 17-61 | 主动脉旁、髂动脉旁 | 4例单用RTX[1 g/2周或375 mg/(m2·周)×4周]治疗，16例泼尼松联合RTX(方案如上) | 75%(15/20)达临床缓解；3例复发；1例死亡；1例并发慢性淋巴细胞白血病 |
| Boyeva等[18] | 10 | 8/2 | 58.5 | / | / | RTX 1 g/2周×2次 | 肌酐、C反应蛋白下降；2例感染 |
| Wallwork等[19] | 26 | 22/4 | 55 | 2.8-4.2 | 主动脉旁、髂动脉旁 | 19例单用RTX 1 g/2周×2次；7例泼尼松联合RTX(方案如上) | 88%(22/25)影像学肿块缩小10%；100%(19/19)症状消失；25%(4/16)红细胞沉降率降至正常；20%(2/10)C反应蛋白降至正常；3例感染 |
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