血管内皮生长因子及其受体抑制剂相关性高血压病理生理机制及临床诊疗的研究进展

Research progress in pathophysiological mechanism and clinical diagnosis and treatment of hypertension associated with vascular endothelial growth factor and its receptor inhibitors

摘要

肿瘤治疗相关心血管毒性（CTR-CVT）逐渐成为影响肿瘤幸存者预后的关键因素。以血管内皮生长因子（VEGF）为靶点研发的VEGF及其受体抑制剂（VEGFIs）作为新型抗肿瘤药物现已广泛应用于临床，可延长肿瘤患者的生存周期，改善患者预后，但VEGFIs诱导的高血压作为其最常见的CTR-CVT，可能会限制和影响其应用并引起严重心血管疾病（CVD）。对应用VEGFIs治疗的肿瘤患者应密切监测血压，早期评估，优化管理，使患者获得最佳的抗肿瘤疗效和最低的CTR-CVT风险。现就VEGFIs相关性高血压的临床表现、发病机制、诊断和治疗策略进行综述，旨在为临床医生更好地管理和应对VEGFIs相关性高血压提供参考。

Abstract

Cancer therapy-related cardiovascular toxicity（CTR-CVT） is gradually becoming a critical factor affecting the prognosis of cancer survivors. Vascular endothelial growth factor （VEGF） and its receptor inhibitors （VEGFIs）， developed as novel anti-cancer drugs targeting VEGF， are now widely used in clinical practice. They can extend the survival period of the cancer patients and improve the prognosis of the patients. However， the hypertension induced by VEGFIs， as the most common CTR-CVT， may limit and impact their use and leads to severe cardiovascular diseases （CVD）. It is essential to closely monitor blood pressure in the cancer patients treated with VEGFIs， conduct early assessments， and optimize the management to achieve the best anti-cancer efficacy and minimize the risk of CTR-CVT. This review discusses the clinical manifestations， pathogenesis， diagnosis， and treatment strategies of VEGFIs-related hypertension， in order to provide better guidances for managing and addressing VEGFIs-related hypertension for the clinicians.

关键词

抗肿瘤药物 / 血管内皮生长因子及其受体抑制剂 / 血管内皮生长因子受体抑制剂 / 肿瘤治疗相关心血管毒性 / 高血压

Key words

Antineoplastic drug / Vascular endothelial growth factors and its receptor inhibitor / Vascular endothelial growth factor receptor inhibitor / Cancer therapy-related cardiovascular toxicity / Hypertension

Author summay

张 莉（1995-），女，山东省临沂市人，在读硕士研究生，主要从事高血压和冠心病诊治方面的研究。