贝伐珠单抗肾脏损害作用及机制

国际肿瘤学杂志››2014,Vol. 41››Issue (8): 602-605.doi:10.3760/cma.j.issn.1673-422X.2014.08.014

贝伐珠单抗肾脏损害作用及机制

何艺,徐群红,陈雪琴,潘月龙,王鸣

310006南京医科大学附属杭州医院（杭州市第一人民医院）肾内科(何艺、徐群红、王鸣)，肿瘤内科（陈雪琴、潘月龙）

收稿日期:2014-02-25修回日期:2014-03-28出版日期:2014-08-15发布日期:2014-08-14
通讯作者:徐群红，E-mail：helloxqh@sina.com E-mail:徐群红，E-mail：helloxqh@sina.com
基金资助:

杭州市卫生科技计划（2011Z002）；吴阶平医学基金会临床科研专项资助基金(320.6750.12364)

Effects and mechanisms of bevacizumab-induced renal impairment

He Yi, Xu Qunhong, Chen Xueqin, Pan Yuelong, Wang Ming

Department of Nephrology, Hangzhou Hospital Affiliated to Nanjing Medical University (Hangzhou First People′s Hospital), Hangzhou 310006, China

Received:2014-02-25Revised:2014-03-28Online:2014-08-15Published:2014-08-14
Contact:Xu Qunhong E-mail:徐群红，E-mail：helloxqh@sina.com

摘要/Abstract

摘要：贝伐珠单抗在肿瘤靶向治疗中已广泛应用，其最常见不良反应为肾脏损害，表现为蛋白尿，主要机制可能有干扰足细胞内皮血管内皮生长因子（VEGF）轴信号、继发性高血压致肾小球内压增加、内皮受损引起亚急性肾小球血栓性微血管病等。肾脏病理表现以血栓性微血管病为主，其他少见类型包括肾小球病变、肾间质病变、良性肾小球动脉硬化等。故贝伐珠单抗使用期间应密切监测尿蛋白和肾功能变化，及时治疗、减少药物剂量甚至停药，保护患者肾功能。

关键词:贝伐珠单抗,肾脏损害,蛋白尿,肾脏病理

Abstract:Bevacizumab has been widely used in tumor targeting therapy, while the most common adverse reaction is renal impairment, manifested as proteinuria. The main mechanisms may include interfering podocytesendothelial vascular endothelial growth factor(VEGF) axis signals, increasing glomerular pressure caused by secondary hypertension, subacute renal thrombotic microangiopathy caused by endothelial damage and so on. Thrombotic microangiopathy is the main renal pathological type, and other rare types include glomerular lesions, renal interstitial disease, and benign renal arteriolar nephrosclerosis. Therefore, urine protein excretion and renal function should be closely monitored during bevacizumab treatment period for timely treatment, dose reduction or even withdrawal if necessary to ensure renal function.

Key words:Bevacizumab,Renal impairment,Proteinuria,Renal pathology

何艺,徐群红,陈雪琴,潘月龙,王鸣. 贝伐珠单抗肾脏损害作用及机制[J]. 国际肿瘤学杂志, 2014, 41(8): 602-605.

He Yi, Xu Qunhong, Chen Xueqin, Pan Yuelong, Wang Ming. Effects and mechanisms of bevacizumab-induced renal impairment[J]. Journal of International Oncology, 2014, 41(8): 602-605.

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