【摘要】 目的:观察胸腺法新对化疗所致的神经毒性的治疗作用,神经电生理检测对化疗神经毒性的客观评价。方法:60例化疗中出现Ⅱ～Ⅳ级神经毒性的患者,再次原方案化疗时加用胸腺法新,化疗前胸腺法新每天1次,每次1.6 mg,皮下注射,qd。化疗期间除每天一次外,于每次化疗的第2、4天给药2次,每次1.6 mg,皮下注射。直至化疗周期结束或神经毒性症状Ⅰ级以下。化疗期间每周进行临床神经系统毒性评估;胸腺法新化疗前及每周期化疗后行左手正中神经电生理检测。结果:60例患者中29例患者(48.3%)神经系统毒性下降1～2级,其中下降2级11人(18.3%),下降1级18人(30.0%)。使用胸腺法新化疗后有效的患者的正中神经平均潜伏期缩短(P=0.04),平均传导速度加快(P=0.02)及平均动作电位振幅增高(P=0.01)。结论:胸腺法新可改善化疗所致神经毒性。神经电生理检测可能成为评价化疗神经毒性的一个客观评价方法。更多还原

【Abstract】 OBJECTIVE To investigate the efficacy of thymalfasin in the treatment of chemotherapy-induced neurotoxicity based on an objective nerve electrophysiological analysis.METHODS In 60 patients with grade Ⅱ-Ⅳ chemotherapy-induced neurotoxicity,thymalfasin was added to their original chemotherapy regimens(before chemotherapy,thymalfasin 1.6 mg/d for 4 day via subcutaneous injection;during chemotherapy,besides one dose daily,thymalfasin was administered twice on day 2 and day 4 of the chemotherapy cycle,1.6 mg per dose).Thymalfasin was administered until the end of the chemotherapy cycle or the fall of neurotoxicity symptoms below gradeⅠ.During chemotherapy,clinical neurological toxicity assessment was performed each week.And left hand median nerve electrophysiological testing was also conducted before and after the chemotherapy cycle.RESULTS Of the 60 patients,29(48.3%) experienced 1 or 2-grade reduction in their neurotoxicity symptoms,including 2-grade reduction in 11 patients(18.3%) and 1-grade reduction in 18 patients(30.0%).After adding thymalfasin to chemotherapy,the average latency period of the median nerve was shortened(P=0.04),the average conduction velocity was accelerated(P=0.02) and the average action potential amplitude of the median nerve was also increased(P=0.01).CONCLUSION Thymalfasin could improve the neurotoxicity associated with chemotherapy,and nerve electrophysiological analysis may become an objective methodology for assessing chemotherapy-induced neurotoxicity.更多还原