摘要：急性肾损伤 （acute kidney injury，AKI） 是一种常见的与活性氧相关的肾脏疾病，往往伴随着肾脏功能 的急剧下降。此外，AKI经常增加慢性肾脏疾病和终末期肾病的风险。然而目前除了肾透析和肾移植，还没有特 定的治疗措施来治疗 AKI。纳米药物因其良好的物理化学特性，在生物医学中的应用越来越受到人们的关注。研 究在肾脏中具有高蓄积性的纳米药物有助于预防和治疗AKI。论文将纳米药物在AKI治疗应用方面的最新进展作 一综述。

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张道富,毕罗鹏,王艳波. 抗氧化纳米药物治疗急性肾损伤的研究进展[J]. 泌尿外科杂志（电子版）,2021,13(2):81-84. DOI:10.3969/j.issn.1674-7410.2021.02.018.

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急性肾损伤 （acute kidney injury，AKI） 也称 急性肾衰竭，是由多种病因导致的急性肾小球滤过 率下降，以血肌酐增高及尿量减少为主要临床表现 的疾病，具有较高的发病率和死亡率[1] 。目前针对 AKI的治疗仍以早期液体复苏或肾脏替代治疗等干 预为主，缺乏有效的药物治疗手段[2] 。抗氧化剂 N- 乙酰半胱氨酸 （N-acetylcysteine，NAC） 在预防造 影剂导致的 AKI方面取得了一定的成功，但应用该 药的利弊问题仍值得商榷[3] 。 

纳米药物在生物医学中的应用越来越受到人们 的关注，在过去的几十年里，纳米医学在各种疾病 的成像和治疗方面取得了长足进步[4] ，这一进展将促 进 AKI 评估与治疗的进步。本文对纳米药物治疗 AKI的研究进展作一综述。

1 AKI 的诊断标准

2 AKI 的发病机制

3 治疗 AKI 的常用抗氧化剂

4 治疗 AKI 的纳米药物
    4.1 肾靶向的纳米药物
    4.2 具有高肾摄取性的金属抗氧化纳米簇
    4.3 DNA 折纸结构
    4.4 黑磷纳米片

5 结语与展望

5 结语与展望 

近年来，纳米药物因其具有非常大的生物医学 应用前景受到研究人员越来越多的关注，不仅在肿 瘤的早期诊断和治疗，而且在 AKI以及 ROS的相关 疾病中均有显著的治疗效果。提高纳米药物的肾靶 向效率是一个非常重要的研究方面。例如，研究表明 用聚乙二醇 PEG包封 DNA折纸结构可以提高它们的 药代生物学利用度，进而延长肾靶向时间窗。简单 的改变可以有效保护 DNA 折纸结构，免于受血液中 蛋白酶的降解和变性[32] 。未来的研究还要继续关注纳 米粒子的形态、尺寸和表面修饰对肾靶向性的影响。

然而，目前纳米医学的研究主要集中在动物模 型，动物模型虽然可以模拟人类的一些疾病，但在 研究纳米药物的药代动力学时必须将种间差异考虑 进去。另外，纳米粒子在人体中的生物分布较难评 估。因此，从实验室到临床的创新过程仍需要努 力，临床前和临床模型之间的差异在纳米药物的发 展中也应该被仔细考虑。目前，纳米药物在 AKI治 疗中的应用尚处于起步阶段，其毒性、靶向性、清除机制尚不清楚[35] 。相信在不久的将来这些问题会得 到阐明，AKI将会得到更精准、更科学、更安全的治疗。

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