奥沙利铂致周围神经病变的危险因素分析  

Analysis of Risk Factors of Oxaliplatin-induced Peripheral Neuropathy

作　　者：杨眉 严明芳 林雅[1] 张丽[1] 倪高翔 YANG Mei;YAN Mingfang;LIN Ya;ZHANG Li;NI Gaoxiang(Department of Oncology,Affiliated Tumor Hospital of Fujian Medical University(Fujian Tumor Hospital),Fuzhou,Fujian Province,350014 China)

机构地区：[1]福建医科大学附属肿瘤医院(福建省肿瘤医院)肿瘤内科,福建福州350014

出　　处：《中外医疗》2021年第35期143-146,共4页China & Foreign Medical Treatment

基　　金：国家临床重点专科建设项目;福建省自然科学基金卫生行业联合资金新上项目(2020J011111)。

摘　　要：目的探讨胃肠道恶性肿瘤化疗患者中奥沙利铂致周围神经病变(oxaliplatin-induced peripheral neuropathy,OIPN)的危险因素及造成的不良影响。方法方便选取2019年3—8月该院收治的180例胃肠道肿瘤化疗患者作为研究对象,采用心理痛苦温度计量表(distress thermometer,DT)、WHO制定OIPN严重程度的分级标准、焦虑自评量表(anxiety self-rating scale,SAS)和抑郁自评量表(depression self-rating scale,SDS)评估患者心理痛苦程度、OIPN、焦虑状态及抑郁状态。结果共有78.3%(141/180)患者出现OIPN,其中1级为88例,2级为43例,3级为10例,4级为0例。单因素分析显示,年龄、化疗剂量、体质指数(body mass index,BMI)、糖尿病是OIPN的影响因素(P<0.05)。多因素分析显示,年龄、化疗剂量、糖尿病、BMI是OIPN独立危险因素(P<0.05)。OIPN患者的焦虑状态、抑郁状态及心理痛苦水平高于非OIPN患者,差异有统计学意义(P<0.05)。OIPN患者在最近3个月内出现跌倒为31.9%(45/141),高于非OIPN患者的15.4%(6/39),差异有统计学意义(P<0.05)。结论年龄大、化疗剂量多、糖尿病、高BMI是OIPN的高危因素,临床上需要对高危人群加强防范。Objective To investigate the risk factors and adverse effects of Oxaliplatin-Induced Peripheral Neuropathy(OIPN)in patients with gastrointestinal malignant tumor chemotherapy.Methods A total of 180 patients with gastrointestinal tumors undergoing chemotherapy in the hospital from March to August 2019 were conveniently selected as the research objects.Adopting the distress thermometer(DT),WHO's OIPN severity grading standard,anxiety self-rating scale(SAS)and depression self-rating scale(SDS).Assessed the patient's degree of psychological distress,OIPN,anxiety and depression.Results A total of 78.3%(141/180)patients had OIPN,of which 88 cases were grade 1,43 cases were grade 2,10 cases were grade 3,and 0 cases were grade 4.Univariate analysis showed that age,chemotherapy dose,body mass index(BMI),and diabetes were the influencing factors for OIPN(P<0.05).Multivariate analysis showed that age,chemotherapy dose,diabetes,and BMI were independent risk factors for OIPN(P<0.05).The anxiety,depression and psychological distress levels of OIPN patients were higher than those of non-OIPN patients,the difference was statistically significant(P<0.05).The rate of falls in OIPN patients in the last 3 months was 31.9%(45/141),which was higher than 15.4%(6/39)of non-OIPN patients,the difference was statistically significant(P<0.05).Conclusion Older age,high chemotherapy doses,diabetes,and high BMI are high-risk factors for OIPN.It is necessary to strengthen prevention of high-risk groups in clinical practice.

关 键 词：胃肠道肿瘤 奥沙利铂致周围神经病变 心理痛苦 焦虑 抑郁 

分 类 号：R587.2[医药卫生—内分泌]