文拉法辛联合谷胱甘肽防治奥沙利铂所致神经毒性的观察和随访  

Clinical observation and follow-up study on oxalipatin-induced neurotoxicity in patients treated with venlafaxine combined with glutathione

作　　者：吕晶晶[1] 邹明雷[1] 张芳[1] 

机构地区：[1]河南省焦作市第二人民医院肿瘤内科一区,焦作454000

出　　处：《临床医学》2016年第3期6-8,共3页Clinical Medicine

摘　　要：目的观察和分析文拉法辛联合谷胱甘肽防治奥沙利铂所致神经毒性的发生和恢复情况。方法应用奥沙利铂辅助治疗肠癌和胃癌患者共90例,随机分为对照组和观察组,每组45例,对照组给予5%葡萄糖联合维生素B6治疗,观察组给予文拉法辛联合谷胱甘肽治疗,观察两组神经毒性的发生情况,应用NTX-12自评量表对患者长期遗留神经毒性进行随访和分析。结果对照组和治疗组在化疗4、8、12周期时神经毒性发生率分别为40.0%、77.8%、83.9%和24.4%、44.4%、46.5%。慢性神经毒性在两组均具有明显的剂量累积性。两组患者NTX-12评分变化在化疗后6个月比较差异有统计学意义(P<0.05),化疗后12个月差异未见统计学意义。对照组和观察组患者在化疗后6、12个月遗留神经毒性分别为44.5%、33.3%和35.6%、22.2%,其中3级分别为6.7%、4.4%和2.2%、2.2%。结论文拉法辛联合谷胱甘肽可以减轻奥沙利铂所致神经毒性,并且有助于神经毒性的恢复。Objective To observe and analyze the oxaliplatin-induced neurotoxicity in patients treated with venlafaxine combined with glutathione. Methods Ninety patients with resectable digestive system tumor who received adjuvant therapy with oxaliplatin were randomly divided into two groups. Patients in treatment group were treated with glutathione combined venlafaxine,while patients in control group were given 5% glucose and vitamin B6 treatment. The incidence and severity of neurotoxicity was recorded. A 12-item neurotoxicity questionnaire（ NTX-12） was used for assessment of whether and how excess neurotoxicity persists. Results The incidence of neurotoxicity in the control group and the treatment group after chemotherapy 4,8,12 cycles were 40. 0%,77. 8%,83. 9% and 24. 4%,44. 4%,46. 5%. Chronic neurological toxicity in both groups had significant dosecumulative. Six months after chemotherapy,there was significant difference in NTX-12 scores between the two groups,while no significant difference in 12 months after chemotherapy. Six months after chemotherapy,44. 5% patients in control group and33. 3% patients in treatment group suffered neurotoxicity in various grades,with 6. 7% and 4. 4% patients reporting 3 grades.Twelve months after chemotherapy,35. 6% patients in control group and 22. 2% patients in treatment group had neurotoxicity,of which 3 grade were both 2. 2%. Conclusion Venlafaxine combined with glutathione can reduce oxaliplatin-induced neurotoxicity,and can help restore neurotoxicity.

关 键 词：文拉法辛 谷胱甘肽 奥沙利铂 神经毒性 

分 类 号：R730.53[医药卫生—肿瘤]