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抗表皮生长因子受体(EGFR)单克隆抗体对多种实体肿瘤的治疗具有重要意义,但这类药物可引起离子紊乱如低镁血症、低钙血症和低钾血症,早期症状因不够典型而容易被忽视.EGFR较多的表达于肾远曲小管和集合管,而抗EGFR单克隆抗体抑制了离子在肾髓袢升支粗段的重吸收,从而使镁离子在尿中的排泄增多,低镁血症继而引起低钙血症和低钾血症.不同的靶向药物以及不同肿瘤发生部位所出现的离子紊乱情形各有不同.低镁血症发生的风险与治疗时间、患者年龄及基础血清镁值相关.低镁血症倾向于可作为预后较佳的预测因素.3级或4级低镁血症需要延长靶向治疗间隔时间,同时静脉补充离子治疗,通常低镁血症是可逆的.该文参考既往的临床试验和研究,讨论离子紊乱的发生率、机制、危险因素、治疗以及疗效预测.“,”Currently, the monoclonal antibody against epidermal growth factor receptor (EGFR) is of great significance for the treatment of multiple solid tumors.But such drugs can cause electrolyte disorders such as hypomagnesemia, hypocalcemia and hypokalemia.The early symptoms can be easily overlooked.With EGFR expressed in the distal convoluted tubules and collecting duct, the monoclonal antibodies inhibit the ions reabsorption in the renal medullary loop ascending branch, so that the excretion of magnesium ions in the urine increase.Hypocalcemia and hypokalemia occur subsequently.Different target drugs and different tumors have different incidence.The risk of hypomagnesemia is associated with treatment duration, patient age, and basal serum magnesium values.Patients who develop hypomagnesemia are more likely to have better prognosis.The treatment interval need to be extended when Grade 3 or 4 hypomagnesemia happen, while received intravenous electrolyte replacement.It is usually reversible.Using the previous clinical trials and studies, we discuss the incidence, mechanisms, risk factors, treatment and prognosis of electrolyte disorders induced by anti-EGFR targeted agents.