神经电生理评价胸腺法对新化疗所致神经毒性的临床观察  

Evaluation on the efficacy of thymalfasin in the treatment of chemotherapy-induced neurotoxicity based on nerve electrophysiological analysis

作　　者：邱峰[1,2] 尹燕军[2] 余锋[2] 项晓军[2] 张凌[2] 熊建萍[2] 

机构地区：[1]华中科技大学同济医学院附属同济医院,湖北武汉430030 [2]南昌大学第一附属医院,江西南昌330006

出　　处：《中国医院药学杂志》2013年第6期478-481,共4页Chinese Journal of Hospital Pharmacy

摘　　要：目的:观察胸腺法新对化疗所致的神经毒性的治疗作用,神经电生理检测对化疗神经毒性的客观评价。方法:60例化疗中出现Ⅱ～Ⅳ级神经毒性的患者,再次原方案化疗时加用胸腺法新,化疗前胸腺法新每天1次,每次1.6 mg,皮下注射,qd。化疗期间除每天一次外,于每次化疗的第2、4天给药2次,每次1.6 mg,皮下注射。直至化疗周期结束或神经毒性症状Ⅰ级以下。化疗期间每周进行临床神经系统毒性评估;胸腺法新化疗前及每周期化疗后行左手正中神经电生理检测。结果:60例患者中29例患者(48.3%)神经系统毒性下降1～2级,其中下降2级11人(18.3%),下降1级18人(30.0%)。使用胸腺法新化疗后有效的患者的正中神经平均潜伏期缩短(P=0.04),平均传导速度加快(P=0.02)及平均动作电位振幅增高(P=0.01)。结论:胸腺法新可改善化疗所致神经毒性。神经电生理检测可能成为评价化疗神经毒性的一个客观评价方法。OBJECTIVE To investigate the efficacy of thymalfasin in the treatment of chemotherapy-induced neurotoxicitybased on an objective nerve electrophysiological analysis. METHODS In 60 patients with grade Ⅱ-Ⅳ chemotherapy-inducedneurotoxicity, thymalfasin was added to their original chemotherapy regimens （before chemotherapy, thymalfasin l. 6 mg/d for4 day via subcutaneous injection; during chemotherapy, besides one dose daily, thymalfasin was administered twice on day 2and day 4 of the chemotherapy cycle, 1.6 mg per dose）. Thymalfasin was administered until the end of the chemotherapy cycleor the fall of neurotoxicity symptoms below grade Ⅰ. During chemotherapy, clinical neurological toxicity assessment was per-formed each week. And left hand median nerve electrophysiological testing was also conducted before and after the chemothera-py cycle. RESULTS Of the 60 patients, 29 （48. 3%） experienced 1 or 2-grade reduction in their neurotoxicity symptoms, in-cluding 2-grade reduction in 11 patients （ 18. 3% ） and 1-grade reduction in 18 patients （30. 0 %）. After adding thymalfasin tochemotherapy, the average latency period of the median nerve was shortened （P =0. 04）, the average conduction velocity wasacceler＋ted （P = 0. 02） and the average action potential amplitude of the median nerve was also increased （P = 0. 01 ）. CONCLU-SION Thymalfasin could improve the neurotoxicity associated with chemotherapy, and nerve electrophysiological analysis maybecome an objective methodology for assessing chemotherapy-induced neurotoxicity.

关 键 词：胸腺法新 化疗 神经系统毒副作用 神经电生理 

分 类 号：R969.4[医药卫生—药理学]