肿瘤化疗所致恶心呕吐的发生机制和药物治疗的研究进展_张晓静.pdf

　　348 　　20067 44 　 ONCOLOGY ROGRESS, July 2006, Vol.4, No.4 # 张晓静　张　频 　　, 100021 ○ 综 　化疗所致恶心、 呕吐 (CINV)是肿瘤患者最常见的不良反应。 如果没有镇吐 治疗, 70%～80% 受化疗的患者会出现恶心、 呕吐症状。 其程度受化疗药物致吐强弱 述 等多因素的影响。在20 世纪90 年代5-HT3 受体阻滞剂和地塞米松的联合应用使得70% 的急性CINV 得到了有效的控制。近年来开发了新 一代半衰期更长、 亲和力更高的5- HT 受体阻滞剂palonosetron (帕洛诺司琼)。此外, 随着对 物质和NK-1 受体研究的深 3 入以及NK-1 受体阻滞剂aprepitant 的问世, 急性和迟发性CINV 的完全缓解率有了进一 步提高。根据近年的新进展和NCCN 止吐治疗指南新版本的修订, 本文综述了CINV 的机 制和药物治疗的研究进展。 关键词　CINV　　5-HT 　NK1 3 中图分类号　R730.53　　　文献标识码　A Advances in mechanism and treatment of chemotherapy-induced nausea and vomiting Zhang Xiaojing　　Zhang in Cancer Hospital, CAMS UMC, Beijing 100021, China Abstract 　Chemotherapy plays a significant role in the combined therapy of tumour.Chemotherapeutic regimens have improved and are more finely targeted than in the past, but chemotherapy-induced nausea and vomiting (CINV)remains a major obstacle and affects patients satisfaction with treatment.About 70%～ 80%patients will face CINV without pretreatment.Efforts to improve antiemetic control further are ongoing. First-generation serotonin receptor antagonists combined with dexamethasone greatly improved the control of CINV during the 1990s.The new advancement involves the use of a new 5-HT receptor antagonist (palono-