Page 137 - 《中国药房》2025年2期
P. 137
3 结语 markers of kidney injury in human proximal tubule mono‐
多黏菌素相关 AKI 的高发率和复杂机制使其成为 layers in vitro[J]. Antibiotics,2024,13(6):530.
临床抗感染治疗中的重要挑战。近年来,新型生物标志 [ 8 ] SHAFIK M S,EL-TANBOULY D M,BISHR A,et al. In‐
sights into the role of PHLPP2/Akt/GSK3β/Fyn kinase/
物的研究取得了显著进展。CysC、KIM-1、NGAL 等新
Nrf2 trajectory in the Reno-protective effect of rosu-
型生物标志物,凭借其在AKI早期预测中的高灵敏度和
vastatin against colistin-induced acute kidney injury in rats
特异性,逐渐显示出了相较于传统标志物的诊断优势,
[J]. J Pharm Pharmacol,2023,75(8):1076-1085.
特别是在肾损伤尚未表现出显性病理变化时,这些标志
[ 9 ] NARAKI K,GHASEMZADEH RAHBARDAR M,
物就能够反映微小的细胞损伤,可为患者个体化治疗提 RAZAVI B M,et al. The power of trans-sodium croceti‐
供科学依据。然而,新型生物标志物的临床应用仍面临 nate:exploring its renoprotective effects in a rat model of
诸多挑战,检测成本高、技术复杂和缺乏统一的标准化 colistin-induced nephrotoxicity[J]. Naunyn Schmiedebergs
检测流程限制了其大范围推广;同时,部分标志物在特 Arch Pharmacol,2024,397(12):10155-10174.
异性方面存在一定局限,可能会受炎症、基础疾病等多 [10] JIANG X K,ZHANG S,AZAD M A K,et al. Structure-
种因素的影响。未来,优化标志物的检测技术、降低成 interaction relationship of polymyxins with the membrane
本并简化检测流程,将是推动其临床应用的关键;此外, of human kidney proximal tubular cells[J]. ACS Infect
还需通过多中心、大样本的临床研究来验证这些标志物 Dis,2020,6(8):2110-2119.
在多黏菌素相关AKI早期预测中的敏感性和特异性,为 [11] YOON S Y,KIM J S,JEONG K H,et al. Acute kidney in‐
jury:biomarker-guided diagnosis and management[J]. Me‐
将其纳入诊疗指南提供强有力的证据支持,最终实现更
dicina(Kaunas),2022,58(3):340.
高的临床效益和更好的患者预后。
[12] MCKENNA Z J,ATKINS W C,FOSTER J,et al. Kidney
参考文献
function biomarkers during extreme heat exposure in
[ 1 ] HOU J,LONG X,WANG X L,et al. Global trend of anti‐ young and older adults[J]. JAMA,2024,332(4):333-335.
microbial resistance in common bacterial pathogens in
[13] XIN Y,LIU Y Q,LIU L Q,et al. Dynamic changes in the
response to antibiotic consumption[J]. J Hazard Mater, real-time glomerular filtration rate and kidney injury mar-
2023,442:130042. kers in different acute kidney injury models[J]. J Transl
[ 2 ] ARDEBILI A,IZANLOO A,RASTEGAR M. Polymyxin Med,2024,22(1):857.
combination therapy for multidrug-resistant,extensively- [14] LARKI R A,JAMALI B,MEIDANI M,et al. Serum cysta-
drug resistant,and difficult-to-treat drug-resistant Gram- tin C for evaluation of acute kidney injury in adults treated
negative infections:is it superior to polymyxin mono‐ with colistin[J]. J Res Pharm Pract,2018,7(4):178-181.
therapy?[J]. Expert Rev Anti Infect Ther,2023,21(4): [15] ORDOOEI JAVAN A,SHOKOUHI S,SAHRAEI Z,et al.
387-429. Nephrotoxicity of high and conventional dosing regimens
[ 3 ] NANG S C,AZAD M A K,VELKOV T,et al. Rescuing of colistin:a randomized clinical trial[J]. Iran J Pharm
the last-line polymyxins:achievements and challenges[J]. Res,2017,16(2):781-790.
Pharmacol Rev,2021,73(2):679-728. [16] TAJIMA S,YAMAMOTO N,MASUDA S. Clinical pro-
[ 4 ] 陈丽娟,吴晓丽,杨康群,等 . 多黏菌素 B 对多重耐药革 spects of biomarkers for the early detection and/or predic‐
兰阴性细菌感染的疗效与肾毒性分析[J]. 中华全科医师 tion of organ injury associated with pharmacotherapy[J].
杂志,2021,20(9):997-1002. Biochem Pharmacol,2019,170:113664.
CHEN L J,WU X L,YANG K Q,et al. Therapeutic effect [17] LEVEY A S,INKER L A,CORESH J. GFR estimation:
and nephrotoxicity of polymyxin B on multidrug-resistant from physiology to public health[J]. Am J Kidney Dis,
Gram-negative bacteria infection[J]. Chin J Gen Pract, 2014,63(5):820-834.
2021,20(9):997-1002. [18] WAINBERG M,KLOIBER S,DINIZ B,et al. Clinical
[ 5 ] GAI Z B,SAMODELOV S L,KULLAK-UBLICK G A, laboratory tests and five-year incidence of major depres‐
et al. Molecular mechanisms of colistin-induced nephro‐ sive disorder:a prospective cohort study of 433 890 par‐
toxicity[J]. Molecules,2019,24(3):653. ticipants from the UK Biobank[J]. Transl Psychiatry,
[ 6 ] SALES G T M,FORESTO R D. Drug-induced nephroto- 2021,11(1):380.
xicity[J]. Rev Assoc Med Bras(1992),2020,66(Suppl. [19] GENG J W,QIU Y X,QIN Z,et al. The value of kidney
1):s82-s90. injury molecule 1 in predicting acute kidney injury in
[ 7 ] PYE K,TASINATO E,SHUTTLEWORTH S,et al. Com‐ adult patients:a systematic review and Bayesian meta-
parison of the impact of VRP-034 and polymyxin B upon analysis[J]. J Transl Med,2021,19(1):105.
中国药房 2025年第36卷第2期 China Pharmacy 2025 Vol. 36 No. 2 · 255 ·