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顺铂(Cis—platinum)又称为PDD或DDP。本品为铂的金属络合物,有抑制与破坏DNA的功能,也可抑制细胞的有丝分裂。为细胞周期非特异性药物。是一种有效的抗癌化疗药,主要用于睾丸肿瘤、头颈部癌、卵巢癌、乳腺癌、恶性黑色素瘤、恶性淋巴瘤、肺癌及膀胱癌等。 其主要肾毒性与药物蓄积量有关。表现为肾小管功能障碍,肾小球滤过率(GFR)可逆性下降。用大剂量全疗程后肾功能的恢复是不完全的。顺铂肾毒性的主要部位在近端和远端小管。明显的病变有凝固性坏死、间质水肿和肾小管扩长。顺铂象其它的重金属,如汞一样与巯基起作用。因此顺铂的肾毒性很可能是与细胞内铂结合到皮质的巯基基团有关,此巯基基团是激活细胞酶功能,特别膜转输所必须的。组织学损害于外髓质区严重,那里铂浓度也是最高的。人体研究游离铂的清除率比菊糖大,表明铂的清除是净肾小管分泌。
Cis-platinum is also known as PDD or DDP. This product is a platinum metal complex that inhibits and destroys DNA and also inhibits cell mitosis. Non-specific drugs for the cell cycle. Is an effective anti-cancer chemotherapy drug, mainly used for testicular cancer, head and neck cancer, ovarian cancer, breast cancer, malignant melanoma, malignant lymphoma, lung cancer and bladder cancer. Its main nephrotoxicity is related to the amount of drug accumulation. The performance of renal tubular dysfunction, glomerular filtration rate (GFR) decreased reversible. The recovery of renal function after a full dose of treatment is incomplete. The major sites of cisplatin nephrotoxicity are proximal and distal tubules. Obvious lesions have coagulative necrosis, interstitial edema, and tubular enlargement. Cisplatin acts like other heavy metals, like mercury, with sulfhydryl groups. Therefore, the nephrotoxicity of cisplatin is likely to be related to the sulfhydryl group in which intracellular platinum binds to the cortex, and this sulfhydryl group is necessary for the activation of cellular enzyme function, particularly for membrane transfusion. Histological damage is severe in the outer medulla, where the platinum concentration is also highest. Human studies have shown that the clearance of free platinum is greater than that of inulin, indicating that the removal of platinum is a net tubular secretion.