钙镁合剂和甲钴胺预防奥沙利铂所致神经毒性疗效比较  

Efficacy comparison of calcium-magnesium infusion and mecobalamin to prevent the neurotoxicity induced by oxaliplatin

作　　者：杨武[1] 喻永龙 王新帅[2] 朱西平[1] 张振华[1] 

机构地区：[1]安徽省宁国市人民医院肿瘤科,242300 [2]河南科技大学第一附属医院肿瘤中心,河南洛阳471003

出　　处：《蚌埠医学院学报》2013年第1期37-40,共4页Journal of Bengbu Medical College

摘　　要：目的:评估钙镁合剂和甲钴胺对奥沙利铂引起神经毒性的预防作用。方法:采用随机、安慰剂对照的方法,将接受奥沙利铂+氟尿嘧啶+亚叶酸钙方案化疗的90例大肠癌患者随机分为3组,分别给予钙镁合剂、甲钴胺和生理盐水。利用奥沙利铂专用神经毒性分级和神经症状评分(NSS)观察患者神经毒性发生率及严重程度。结果:单纯化疗组、钙镁合剂组、甲钴胺组急性神经毒性发生率分别为93.1%、66.7%、65.5%,差异有统计学意义(P<0.05)。慢性神经毒性,化疗3周期评价时3组之间有统计学意义(P<0.01)。钙镁合剂和甲钴胺组Ⅰ～Ⅲ度神经毒性均低于单纯化疗组(P<0.01和P<0.05),钙镁合剂组和甲钴胺组差异无统计学意义(P>0.05)。化疗6周期时3组差异有统计学意义(P<0.05),钙镁合剂组神经毒性发生率低于单纯化疗组(P<0.05),但甲钴胺组和单纯化疗组差异无统计学意义(P>0.05)。根据NSS评分,单纯化疗组3周期、6周期时评分均高于其他2组(P<0.01和P<0.05),而钙镁合剂和甲钴胺组差异无统计学意义(P>0.05).结论:钙镁合剂和甲钴胺均能降低奥沙利铂神经毒性的发生率和程度。Objective： To evaluate the effects of calcium-magnesium （Ca/Mg） infusion and mecobalamin on preventing the neurotoxicity induced by oxaliplatin. Methods：Taking the method of random and placebo control,90 patients with colon cancer treated with oxaliplatin ＋ fluorouracil ＋ calcium folinate chemotherapy were randomly divided into three groups which were treated with Ca/Mg infusion,mecobalamin and normal saline, respectively. According to Sanofisyn thelabo and neuropathy symptom score （NSS）, the neurotoxicity incidence and severity of all patients were observed. Results：The actue neurotoxieity incidence of normal saline, Ca/Mg infusion and mecobalamin group were 27 cases（93.1% ）, 20 cases （ 66.7% ） and 19 cases （ 65.5% ）, respectively, which differences were statistical significance （ P 〈 0.05 ）. There were significant difference between the chronic neurotoxicity of three groups after 3 cycles of chemotherapy（ P 〈0.01 ）. The Ⅰ - Ⅲ degree neurotoxicity of Ca/Mg infusion and mecobalamin groups were no difference （P 〉 0. 05） ,but which were lower than that of chemotherapy group （P 〈 0.01 to P 〈 0.05 ）. After 6 cycles of chemotherapy, there were significant differences between the incidence of neurotoxicity of three groups（ P 〈 0.05 ）, the neurotoxicity of Ca/Mg infusion group was lower than that of chemotherapy group （ P 〈 0.05 ）, and the differences of mecobalamin and chemotherapy groups were not statistical significance（P 〉 0.05 ）. The NSS score of chemotherapy group was higher than that of other two groups after 3 and 6 cycles of chemotherapy （ P 〈 0.01 and P 〈 0.05 ）, but for other two groups had no differences （ P 〉 0.05 ）. Conclusions ： Ca/Mg infusion and mecobalamin can decrease the incidence and intensity of neurotoxicity induced by oxaliplatin.

关 键 词：肿瘤 药物疗法 奥沙利铂 神经毒性 钙镁合剂 甲钴胺 

分 类 号：R730.53[医药卫生—肿瘤]