目的 探究利妥昔单抗治疗儿童初发激素敏感型肾病综合征（steroid-sensitive nephrotic syndrome, SSNS）对细胞免疫及细胞因子水平的影响。 方法 回顾性分析2021年12月—2023年3月徐州市儿童医院60例初发SSNS患儿的临床资料，根据是否使用利妥昔单抗治疗分成对照组及观察组，对比两组患儿的复发率、治疗前后的T淋巴细胞亚群和细胞因子的水平及不良反应发生率。 结果 观察组复发率低于对照组（27% vs 73%，P<0.05）。治疗后观察组CD3⁺、CD4⁺ T淋巴细胞计数、CD4⁺/CD8⁺比值及白细胞介素（interleukin, IL）-2升高且高于对照组（P<0.05）。观察组IL-6、肿瘤坏死因子-α水平治疗后下降并低于对照组（P<0.05）。治疗后两组患儿CD8⁺ T淋巴细胞计数下降，γ干扰素升高，IL-10下降，两组比较差异无统计学意义（P>0.05）。两组的不良反应发生率差异无统计学意义（P>0.05）。 结论 利妥昔单抗可降低初发肾病综合征患儿的复发率，且安全性较高，其可通过调节T细胞的数量及功能，以及调节细胞因子的抗炎作用达到治疗效果。

Objective To explore the effect of rituximab on cellular immunity and cytokines in children with new-onset steroid-sensitive nephrotic syndrome (SSNS). Methods Clinical data of 60 children with new-onset SSNS treated at Xuzhou Children's Hospital from December 2021 to March 2023 were retrospectively analyzed. Children were allocated according to rituximab use into a control group (no rituximab) and an observation group (rituximab). The relapse rate, T-lymphocyte subsets and cytokines before and after treatment, and the incidence of adverse reactions were compared between groups. Results The relapse rate was lower in the observation group than in the control group (27% vs 73%, P<0.05). After treatment, CD3⁺ and CD4⁺ T-lymphocyte counts, the CD4⁺/CD8⁺ ratio, and serum interleukin-2 increased in the observation group and were higher than in the control group (P<0.05). Interleukin-6 and tumor necrosis factor-α levels decreased after treatment in the observation group and were lower than in the control group (P<0.05). After treatment, CD8⁺ T-lymphocyte counts decreased, interferon-γ increased, and interleukin-10 decreased in both groups, with no significant differences between the two groups (P>0.05). The incidence of adverse reactions did not differ significantly between the two groups (P>0.05). Conclusions Rituximab can reduce the relapse rate in children with new-onset nephrotic syndrome and shows good safety. Its therapeutic effect is achieved by regulating the number and function of T cells and by modulating the anti-inflammatory effects of cytokines.