奥沙利铂致周围神经病变及其防治研究进展  

Research progress in prevention and treatment of peripheral neuropathy associated with oxaliplatin

作　　者：张学兰[1] 张侠[2] 

机构地区：[1]山西医科大学第二临床医学院临床医学系2013级,太原030001 [2]北京军区总医院肿瘤内科诊治中心,100007

出　　处：《药物不良反应杂志》2016年第2期132-136,共5页Adverse Drug Reactions Journal

摘　　要：奥沙利铂常用于转移性结直肠癌治疗或辅助治疗。奥沙利铂所致周围神经病变是以末梢神经炎为特征的感觉神经病变，呈剂量限制性和依赖性。奥沙利铂所致急性周围神经病变的发生率为86％～95％，发生机制与药物在体内的代谢产物草酸盐有关，临床表现为冷刺激诱发或加剧的肢体末端感觉异常和感觉迟钝，具有可逆性。奥沙利铂所致慢性周围神经病变发生率与剂量相关，具有蓄积性和可逆性，发生机制可能与药物导致神经细胞受损以及改变痛觉信号的调制与传递有关，临床表现为末梢感觉减退或缺失、上下肢麻木等，严重时造成肢体功能障碍。患者在治疗期间避免冷刺激、适当延长药物静脉滴注时间、应用某些药物可预防或减轻奥沙利铂的神经毒性。Oxaliplatin is commonly used in treatment or adjuvant therapy of metastatic colorectal cancer. Oxaliplatin-induced peripheral neuropathy is a sensory neuropathy characterized by peripheral neuritis with dose-limiting and dose-dependent manner. The incidence of acute oxaliplatin-indueed peripheral neuropathy is 86% to 95% and its occurrence is related to the oxalate which is one of oxaliplatin metabolites in the body. The clinical manifestations are mainly reversible extremities paresthesia and dysesthesia induced or exacerbated by the cold stimulation. Oxaliplatin-induced chronic peripheral neuropathy, with accumulative and reversible manner, may be related to the drug-induced nerve cell damage and the change of pain signal modulation and transmission, and its incidence rate is dose-related. The clinical manifestations include peripheral sensory function decrease or absence, upper and lower extremity numbness, and even physical dysfunction. The neurotoxicity of oxaliplatin can be prevented or reduced by the avoidance of the cold stimulation during treatment, appropriate extension of the drug infusion period and the application of certain drugs.

关 键 词：奥沙利铂 周围神经损伤 药物毒性 

分 类 号：R979.1[医药卫生—药品]