硫代硫酸钠在钙性尿毒症性小动脉病中的机制和应用  

The mechanism and clinical application of sodium thiosulfate intreatment of calcific uremic arteriolopathy

作　　者：唐静[1,2] 钟慧[1] 付平[1] TANG Jing;ZHONG Hui;FU Ping(Department of Nephrology,West China Hospital,Sichuan University,Chendu 610041,China)

机构地区：[1]四川大学华西医院肾脏内科,成都610041 [2]攀钢集团总医院肾脏内科,攀枝花617000

出　　处：《临床肾脏病杂志》2020年第9期748-752,共5页Journal Of Clinical Nephrology

基　　金：四川省科技厅支撑计划(2017FZ0092)。

摘　　要：钙性尿毒症性小动脉病(calcific uremic arteriopathy,CUA),又名钙化防御,是一种罕见的、致死性高的血管钙化性疾病,主要发生在行血液透析和腹膜透析的终末期肾病患者。CUA常表现为缺血性皮肤坏死和剧烈疼痛。由于其预后极差,越来越多地受到人们的关注。但目前仍没有关于CUA的高质量临床研究和相应的治疗指南。硫代硫酸钠(sodium thiosulfate,STS)是一种强抗氧化剂,被认为可能通过螯合软组织中沉积钙、上调钙化抑制因子等抑制血管钙化;也被认为有舒张血管、改善血管内皮,从而快速缓解疼痛的作用。STS目前已成为治疗CUA的重要药物。本文就STS治疗CUA的药动学特征、作用机制、用药方法及药物不良反应等进行综述。Calcific uremic arteriopathy(CUA),also known as calciphylaxis,is a rare but devastating disease that predominantly affects patients with end-stage renal disease receiveing dialysis.It is characterized by profoundly painful ischemic skin necrosis and severe pain.Due to its most poor prognosis,increasingly it has attracted more and more attention.However,there are no high quality clinical trials or corresponding treatment guidelines yet.It is thought that Sodium thiosulfate(STS)as a strong antioxidant may allay pain rapidly by chelating the calcium in deposits and up-regulating calcification inhibitors to inhibit vascular calcification;it is also thought to have a role of vasodilating,endothelium function improving,and pain reliving.STS has now become an important medicine for CUA.In this review,we outline the pharmacokinetic characteristics,mechanism,usage,and adverse reactions of STS for CUA.

关 键 词：钙性尿毒症性小动脉病 钙化防御 硫代硫酸钠 

分 类 号：R692.5[医药卫生—泌尿科学]