硫代硫酸钠治疗钙化防御血管钙化机制的研究进展及其争议

Advances and controversies in the mechanism of sodium thiosulfate for vascular calcification of cal⁃ciphylaxis

钙化防御是一种发生于终末期肾病患者的特殊的血管钙化,其早期临床症状不典型,预后差,且缺乏明确的临床指南。目前,在临床上,对于钙化防御的治疗主要是采用以硫代硫酸钠(so⁃dium thiosulfate,STS)为主的综合治疗。STS治疗钙化防御主要通过钙螯合、抗氧化应激、酸中毒、舒张血管和抗炎镇痛作用及钙化抑制因子作用等机制,而随着临床研究的进展,关于这些治疗机制尚存在一些争议。

As a special vascular calcification in patients with end-stage renal disease,calciphy⁃laxis has atypical early clinical symptoms,a poor prognosis and unclear clinical guidelines.Currently so⁃dium thiosulfate(STS)has been a standard agent in the treatment of calciphylaxi.It acts mostly through the mechanisms of calcium chelation,antioxidant stress,acidosis,vasodilation,anti-inflammatory,analge⁃sia and calcification inhibiton.However,there are still some ongoing controversies about these therapeutic mechanisms.