内科理论与实践

内科理论与实践 >

2025 , Vol. 20 >Issue 04: 322 - 327

DOI: https://doi.org/10.16138/j.1673-6087.2025.04.12

病例报告

抗肿瘤药物所致血栓性微血管病样肾损伤2例

  • 王祎宁 ,
  • 陈楠楠 ,
  • 程琳 ,
  • 刘振华 ,
  • 郑晓燕 ,
  • 徐静 ,
  • 潘晓霞 ,
  • 陈永熙 ,
  • 陈晓农
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  • 1.上海交通大学医学院附属瑞金医院 a.肾脏科；b.超声科，上海 200025
    2.上海交通大学医学院附属瑞金医院舟山分院 a.肾脏科；b.超声科；c.呼吸科，浙江 舟山 316000
陈永熙 E-mail: rickychen@sjtu.edu.cn

收稿日期: 2024-11-05

  网络出版日期: 2025-10-27

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Renal thrombotic microangiopathy associated with chemotherapy: two case reports

  • WANG Yining ,
  • CHEN Nannan ,
  • CHENG Lin ,
  • LIU Zhenhua ,
  • ZHENG Xiaoyan ,
  • XU Jing ,
  • PAN Xiaoxia ,
  • CHEN Yongxi ,
  • CHEN Xiaonong
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  • 1a. Department of Nephrology; b. Department of Ultrasound Diagnostic,Ruijin Hospital,Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
    2a. Department of Nephrology; b. Department of Ultrasound Diagnostic; c. Department of Respiratory, Zhoushan Branch,Ruijin Hospital,Shanghai Jiao Tong University School of Medicine, Zhoushan 316000, China

Received date: 2024-11-05

  Online published: 2025-10-27

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摘要

病例1为68岁男性，确诊肺恶性肿瘤3年，贝伐珠单抗治疗中出现蛋白尿，肾功能正常。病例2为70岁男性患者，确诊胃腺癌2年，予以奥沙利铂+亚叶酸钙+氟尿嘧啶方案化疗结束3个月出现蛋白尿，肾功能正常。2例患者肾活组织检查病理均提示血栓性微血管病样改变，治疗均予以沙库巴曲缬沙坦钠联合达格列净，治疗后蛋白尿不同程度下降，肾功能保持正常。

关键词： 血栓性微血管病; 抗肿瘤药物; 肾损伤

本文引用格式

王祎宁 , 陈楠楠 , 程琳 , 刘振华 , 郑晓燕 , 徐静 , 潘晓霞 , 陈永熙 , 陈晓农 . 抗肿瘤药物所致血栓性微血管病样肾损伤2例[J]. 内科理论与实践, 2025 , 20(04) : 322 -327 . DOI: 10.16138/j.1673-6087.2025.04.12

Abstract

Patient 1 was a 68-year-old male who had been diagnosed with a malignant lung tumor for three years. This case developed proteinuria during bevacizumab treatment and had normal renal function. Patient 2 was a 70-year-old male diagnosed with gastric adenocarcinoma for two years, this case developed proteinuria after three months chemotherapy with oxaliplatin, leucovorin, and fluorouracil, but his renal function was normal. Renal biopsy of the two patients showed thrombotic microangiopathy. After treatment with sacubitril/valsartan sodium combined with dapagliflozin, proteinuria in two patients decreased, and their renal function was still stable.

Key words： Thrombotic microangiopathy; Antineoplastic agents; Renal involvement

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