抗肿瘤血管生成类药物致蛋白尿的机制及临床诊治

Mechanism and treatment of proteinuria induced by anti-tumor angiogenesis drugs

血管内皮生长因子(vascular endothelial growth factor,VEGF)及其受体(vascular endothelial growth factor receptor,VEGFR)在生理和病理性血管生成中发挥关键作用。由于恶性肿瘤生长离不开新生血管支持,因此抑制VEGF/VEGFR系统的抗肿瘤血管生成药物已成为肿瘤药物治疗重要手段之一。随着药物在临床上被广泛应用,部分患者在用药过程中发生以蛋白尿为表现的肾毒性,其发病机制尚不明确。现就抗肿瘤血管生成药物临床使用致蛋白尿的发生率、机制及临床诊治作一综述,旨在为临床用药提供参考。

Vascular endothelial growth factor(VEGF)and its receptor(VEGFR)play a crucial role in physiological and pathological angiogenesis.Since the growth of malignant tumors cannot be separated from the support of neovascularization,anti-tumor angiogenesis drugs that inhibit VEGF/VEGFR system have become one of the important means of tumor drug therapy.With the wide application of drugs in clinical practice,nephrotoxicity manifested as proteinuria occurs in some patients during the course of medication,and its pathogenesis is still unclear.This article reviews the incidence,mechanism,clinical diagnosis and treatment of proteinuria induced by the clinical use of anti-tumor angiogenesis drugs,in order to provide reference for clinical medication.