药物性肾损伤机制研究进展progressofthestudyof-药学学报.pdfVIP

药学学报 Acta Pharmaceutica Sinica 2010, 45 ( 10) : 1199 1204 ·1199 · 综述 药物性肾损伤机制研究进展 翔, 宫丽崑, 任 进* ( 中国科学院上海生命科学院 上海 物研究所新 研究国家重点实验室, 上海 201203) 摘要: 药物性肾损伤在新 开发过程和临床用 中十分常见, 许多药物可引起不同程度的肾脏损伤, 包括 肾小管间质性、肾小球性和肾血管性疾病。深入研究药物性肾损害产生的分子机制, 对降低新 开发风险、临 床合理用药、早期发现不良反应和采取有效防治措施均有着重要意义。 关键词: 药物性肾损伤; 性肾小管坏死; 小管间质性肾炎 中图分类号: R965 文献标识码:A 文章编号: 05 13-4870 (2010) 10-1199-06 Progress of the study of mechanism on drug induced kidney injury * XUE Xiang, GONG Li-kun, REN Jin (State Key Laboratory of Drug Research, Shanghai Institute of M ateria M edica, Shanghai Institute for Biological Sciences, Chinese Academy of Sciences, Shanghai 201203, China) Abstract: Drug-induced nephrotoxicity is very common in both new drug development and clinic practice. Various drugs can induce kidney injuries, including tubulointerstitial, glomerular and renal vascular disease. To investigate the mechanism of drug induced nephrotoxicity is important for risk reduction of new drug development, reasonable drug usage, early discovery and effective prevention/treatment of adverse effects in clinics. Key words: drug induced kidney inj ury; acute tubular necrosis; tubulointerstitial nephritis 大部分药物及其代谢产物经肾脏排出体外, 因 1 抗感染类药物 而药物引起的肾损害发生率很高。研究显示药物导 1.1 氨基糖苷类 氨基糖苷类抗生素(aminoglycosides, 致 性肾小管坏死 (acute tubular necrosis, ATN) 或 AG) 广泛应用于革兰阴性细菌感染的治疗, 然而肾 性间质性肾炎 (acute interstitial nephritis, AIN) 的 毒性限制了其临床应用。AG 肾毒性机制尚不完全清 发生率高达 18.3%, 其中抗生素肾损害的发生率达 楚。AG