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反复使用止痒药纳呋拉啡后血液透析患者出现脱发：血管生成受损对脱发的影响

Hair Loss in a Hemodialysis Patient after Repetitive Use of the Antipruritic Drug Nalfurafine: Implications of Impaired Angiogenesis for Hair Loss.

作者信息

Kida Yujiro, Itoh Shiro, Yoshimi Sei, Kobayashi Yuko, Izumi Masaaki

机构信息

Nishidai Dialysis Center, Japan.

Department of Nephrology, Takashimadaira Central General Hospital, Japan.

出版信息

Intern Med. 2025 May 1;64(9):1371-1379. doi: 10.2169/internalmedicine.4249-24. Epub 2024 Oct 11.

DOI:10.2169/internalmedicine.4249-24
PMID:39401915
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12120231/
Abstract

A 47-year-old man who presented with scalp hair loss was transferred to our dialysis facility 3 months after hemodialysis initiation. He noticed systemic hair loss one month after the initiation of dialysis. Because the antipruritic drug nalfurafine was the only drug that had been newly added to his regular medication after he started hemodialysis, we stopped its prescription. His hair loss was completely ameliorated for the next five months. We speculated that κ-opioid receptor activation by nalfurafine caused blood capillary regression around the hair follicles, leading to cessation of hair growth and subsequent hair fallout.

摘要

一名47岁的男性患者因头皮脱发前来就诊，在开始血液透析3个月后被转诊至我们的透析中心。他在透析开始1个月后出现全身性脱发。由于抗瘙痒药物纳呋拉啡是他开始血液透析后常规用药中唯一新添加的药物，我们停用了该药物的处方。在接下来的五个月里，他的脱发完全得到了改善。我们推测，纳呋拉啡激活κ-阿片受体导致毛囊周围毛细血管消退，从而导致头发生长停止和随后的脱发。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d0c4/12120231/9bfa80b06cd7/1349-7235-64-1371-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d0c4/12120231/80b1577b36dd/1349-7235-64-1371-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d0c4/12120231/1e9731c06ee3/1349-7235-64-1371-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d0c4/12120231/9bfa80b06cd7/1349-7235-64-1371-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d0c4/12120231/80b1577b36dd/1349-7235-64-1371-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d0c4/12120231/1e9731c06ee3/1349-7235-64-1371-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d0c4/12120231/9bfa80b06cd7/1349-7235-64-1371-g003.jpg

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本文引用的文献

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Topical administration of the kappa opioid receptor agonist nalfurafine suppresses corneal neovascularization and inflammation.局部给予κ阿片受体激动剂纳呋拉啡可抑制角膜新生血管和炎症。
Sci Rep. 2021 Apr 21;11(1):8647. doi: 10.1038/s41598-021-88118-6.
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Morphine acts on spinal dynorphin neurons to cause itch through disinhibition.吗啡通过去抑制作用作用于脊髓强啡肽神经元而引起瘙痒。
Sci Transl Med. 2021 Feb 3;13(579). doi: 10.1126/scitranslmed.abc3774.
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Peritubular Capillary Rarefaction: An Underappreciated Regulator of CKD Progression.肾小管周毛细血管稀疏：CKD 进展的一个被低估的调节因子。
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