高原环境下紫杉烷类化疗诱导外周神经病变的研究进展
Journal: Basic Medical Theory Research DOI: 10.12238/bmtr.v7i5.16516
Abstract
紫杉烷类药物是临床抗肿瘤的一线药物,对其进行合理应用,可显著延长患者生存期,但其易诱发化疗诱导外周神经病变(chemotherapy-induced peripheral neuropathy,CIPN)。CIPN临床表现多样(感觉异常、疼痛、运动障碍),机制涉及微管动力学紊乱、线粒体损伤及氧化应激,但目前缺乏特异性干预手段,且个体差异显著。高原环境(海拔>2500m)具有低氧、低压和强紫外线三重胁迫,可通过“能量代谢失衡-血管缺血-氧化炎症”轴放大紫杉烷的神经毒性,使CIPN发生率显著升高,症状更重且恢复更慢。因此,亟需针对高原环境下梳理CIPN机制、临床特征及防治策略,以期指导高原地区肿瘤患者个体化用药。本文系统综述紫杉烷类药物引发CIPN的病理生理机制,重点分析高原环境通过低氧导致的能量代谢失衡、低压引发的血管功能损伤及强紫外线加剧的炎症反应等途径,对CIPN发生发展的影响,阐述高原地区CIPN的临床特征与预防策略,并提出未来研究方向,为高原地区肿瘤患者的安全用药提供参考。
Keywords
紫杉烷；高原低氧；化疗诱导外周神经病变；个体化防治
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