皮质类固醇激素在化疗引起的恶心呕吐防治中的应用  

Application of corticosteroids in the prevention and treatment of chemotherapy induced nausea and vomiting

作　　者：尹瑞华 汤婉芬 傅健飞 YIN Ruihua;TANG Wanfen;FU Jianfei(School of Medicine,Shaoxing University,Shaoxing 312000;Oncology Department,Jinhua Central Hospital,Jinhua 321000,China)

机构地区：[1]绍兴文理学院医学院,浙江绍兴312000 [2]金华市中心医院肿瘤内科,浙江金华321000

出　　处：《临床医学研究与实践》2023年第12期187-190,共4页Clinical Research and Practice

基　　金：2020年度第二批金华市科学技术研究计划项目(No.2020-3-028)。

摘　　要：化疗引起的恶心呕吐(CINV)是化疗最常见的非血流学毒性。尽管在过去的几十年里CINV的防治取得了较大进展,包括多个5-羟色胺3(5-HT3)受体拮抗剂、神经激肽-1(NK1)受体拮抗剂、奥氮平、沙度利胺在临床上的应用,然而皮质类固醇激素在CINV管理中依然占据相当重要的地位。皮质类固醇激素单药不仅是极低危致吐方案的一线选择,而且其和5-HT3受体拮抗剂、NK1受体拮抗剂的联合使用也是目前临床防治其他强度化疗方案CINV的一线方案。本文对皮质类固醇激素在CINV中的作用机制、不同皮质类固醇激素药物选择、剂量推荐、给药时长、特殊人群中应用、不良反应等进行综述,以期指导临床更优化使用皮质类固醇激素。Chemotherapy induced nausea and vomiting(CINV)is the most common non-hematologic toxicity of chemotherapy.The great progress has been made in the prevention and treatment of CINV in the past few decades,including the clinical application of multiple 5-hydroxytryptamine 3(5-HT3)receptor antagonists,neurokinin-1(NK1)receptor antagonists,olanzapine and thalidomide.However,corticosteroids still plays an important role in the management of CINV.Corticosteroids is the first-line choice for the prevention of mini-risk emetogenic chemotherapy regimens,and its combination with 5-HT3 receptor antagonist and NK1 receptor antagonist is also the first-line regimen for the prevention and treatment of CINV in other intensity chemotherapy regimens.This paper reviews the mechanism of action of corticosteroids in CINV,the selection of different corticosteroids,dose recommendation,duration of administration,application in special populations and adverse reactions and so on,in order to guide the clinical use of corticosteroids.

关 键 词：皮质类固醇激素 化疗引起的恶心呕吐 预防和治疗 

分 类 号：R730.5[医药卫生—肿瘤]