草酸铂所致周围神经毒性的临床药物防治观察  

TREATMENT AND PREVENTION OF OXALIPLATIN-INDUCED PERIPHERAL NERVE TOXICITY

作　　者：张瞳光[1] 杜利力 于晓丽 孔鲁[1] 韩灵敏 

机构地区：[1]青岛市市立医院东院区神经外科,山东青岛266071 [2]青岛市商业职工医院肿瘤内科

出　　处：《齐鲁医学杂志》2014年第6期502-504,共3页Medical Journal of Qilu

摘　　要：目的观察临床用药对草酸铂所致周围神经毒性的防治效果。方法将134例应用草酸铂病人随机分为观察组(41例)、对照组(55例)和空白组(38例)。观察组从化疗开始每日给予单唾液酸四己糖神经节苷脂20mg静脉滴注,共14d;对照组化疗同步每日给予还原型谷胱甘肽2.4g静脉滴注,共14d;空白组化疗同时不应用任何神经保护药物。4周期化疗后评价3组病人周围神经毒性发生率及分度情况。结果各组均未发生4度周围神经毒性反应。观察组2、3度反应发生率分别为12.20%和2.44%,较对照组(29.09%和7.27%)和空白组(28.95%和10.53%)明显为低,差异有统计学意义(Z=-2.607、2.890,P<0.05)。对照组与空白组间差异无统计学意义(P>0.05)。结论由草酸铂引起的周围神经毒性反应临床应用单唾液酸四己糖神经节苷脂防治效果较好,值得推广。Objective To observe the effects of drugs used in the prevention and treatment of peripheral nerve toxicity （PNT） caused by oxaliplatin. Methods A total of 134 patients treated with oxaliplatin were divided in random into observation group （n= 41）, control group （n = 55） and blank group （n = 38）. Patients in the observation group received intravenous drip of monosialoteterahexosyl ganglioside （MTHG）, 20 mg/d for 14 d, starting from the day of oxaliplatin chemotherapy; those in the control group received daily intravenous drip of 2.4 g of reduced glutathione for 14 days from the same day as chemotherapy started; those in the blank group received no any neuroprotective agents during chemotherapy. The incidence and its scale division of PNT in the three groups were assessed after four cycles of chemotherapy. Results No grade 4 PNT reactions were observed in the three groups. The incidences of grades 2 and 3 toxic reaction in the observation group were 12.2% and 2.44%, respectively, which were obvious｜y lower than the control group, 29.09% and 7.27%, and the blank group, 28.95% and 10.53%, respectively, the differences were statistically significant （Z=-2. 607,2. 890;P〈 0.05）, the differences of that between the control and the blank groups were no significant （P〉0.05）. Conclusion Control efficiency of using monosialoteterahexosyl ganglioside is better for oxaliplatin induced peripheral nerve toxicity, which is worth promoting clinical medication.

关 键 词：药物毒性 周围神经 草酸铂 铂化合物 药物疗法 联合 

分 类 号：R730.5[医药卫生—肿瘤] R595.479.1[医药卫生—临床医学]