奥沙利铂致周围神经病变临床特征及与炎症指标的相关性研究  

Correlations Clinical Characteristics with Inflammatory Indexes in Oxaliplatin-induced Peripheral Neuropathy

作　　者：王莹 李亚昙[2] WANG Ying;LI Ya-tan(Drug Instrument Supervision and Inspection Station,Support Department of Xinjiang Military Command,Urumqi 830052,China;The Second Affiliated Hospital of Xinjiang Medical University,Urumqi 830052,China)

机构地区：[1]新疆军区保障部药品仪器监督检验站,新疆乌鲁木齐830052 [2]新疆医科大学第二附属医院同,新疆乌鲁木齐830052

出　　处：《解放军药学学报》2024年第3期266-269,共4页Pharmaceutical Journal of Chinese People's Liberation Army

基　　金：新疆维吾尔自治区自然科学基金面上项目,No.2023D01C115。

摘　　要：目的探讨奥沙利铂诱导周围神经病变(OIPN)患者临床特征与炎症因子的相关性,为进一步研究神经炎症损伤机制提供临床依据和用药指导。方法回顾性分析某三甲医院2021年9月-2023年8月OIPN患者基本信息、临床表现、肿瘤标志物水平及炎症相关检测结果变化趋势,Pearson法分析各炎症相关指标间的相关性,Logistics回归分析OIPN的危险因素,ROC曲线下面积判断危险因素的诊断价值。结果该院OIPN的发生率为82.00%;其中发生四肢疼痛者占53.66%(P=0.008)。OIPN患者外周血白介素-6(IL-6)、C反应蛋白(CRP)、降钙素原水平异常升高且显著高于正常值范围(P=0.020,P=0.000,P=0.002)。淋巴细胞百分比和CD3+、CD4+T细胞数均明显低于正常对照组(P=0.000,P=0.012,P=0.000)。Pearson法提示淋巴细胞百分比的减少与CRP异常升高之间呈显著负相关性(P=0.026)。多因素Logistics回归分析结果提示IL-6、CRP是OIPN发生的危险因素(OR=1.13、1.515,P=0.035、0.008),ROC曲线下面积提示IL-6、CRP对OIPN的诊断均具有显著意义(AUC分别为0.870、0.886,P<0.05)。结论通过分析该院OIPN患者的临床表现及炎症指标变化的相关性,为进一步研究OIPN的调控机制提供了有利依据。Objective To explore the correlations between clinical characteristics and inflammatory factors in patients with oxaliplatin induced peripheral neuropathy(OIPN),and to provide data for studies on the mechanism of neuroinflammatory injury.Methods The basic data of patients with OIPN,clinical manifestations,levels of tumor markers and changes in the results of inflammation-related tests treated in a hospital between September 2021 and August 2023 was retrospectively analyzed.The Pearson method was adopted to analyze the correlations between various inflammation-related indicators while logistic regression was used to analyze the risk factors for OIPN.The area under the ROC curve was used to determine the diagnostic value of these risk factors.Results The incidence of OIPN in this hospital was 82.00%and 53.66%of the patients with OIPN had limb pain(P=0.008).The levels of interleukin-6(IL-6),Creactive protein(CRP),Procalcitonin(PCT)in peripheral blood of patients were abnormally elevated and significantly higher than the normal range(P=0.020,P=0.000,P=0.002).The percentage of lymphocytes and the number of CD3+and CD4+T cells were significantly lower than those of the normal control group(P=0.000,P=0.012,P=0.000).The Pearson method suggested that there was a significant negative correlation between the decreased percentage of lymphocytes and the abnormal increase of CRP(P=0.026).The results of multi-factor logistic regression analysis indicated that IL-6 and CRP were risk factors for OIPN(OR=1.13、1.515,P=0.035、0.008),and the area under the ROC curve suggested that IL-6 and CRP were significant for the diagnosis of OIPN(AUC:0.870、0.886,P<0.05).Conclusion Analysis of the correlations between clinical manifestations and inflammatory index indicators of OIPN could contribute to subsequent studies on the regulatory mechanism OIPN.

关 键 词：周围神经病变 奥沙利铂 炎症因子 药品不良反应 

分 类 号：R969.3[医药卫生—药理学]