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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。
Objective: To observe the therapeutic effects of thymus on neurotoxicity caused by chemotherapy, and to evaluate the neurotoxicity of neuroelectrophysiology on chemotherapy. Methods: Sixty patients with grade Ⅱ ~ Ⅳ neurotoxicity were treated with thymus plus chemotherapy once a day, once a day, 1.6 mg once daily by subcutaneous injection, qd. In addition to chemotherapy during the day, the first two days of each chemotherapy 2 dosing, 1.6 mg, subcutaneous injection. Until the end of the chemotherapy cycle or neurotoxic symptoms below grade Ⅰ. The clinical nervous system toxicity was evaluated every week during chemotherapy. Thymus method was used to detect the left middle front nerve electrophysiology before and after chemotherapy. Results: Twenty-nine of the 60 patients (48.3%) had neurotoxicity decreased by 1 to 2, with 11 (18.3%) declines at level 2 and 18 (30.0%) declines at level 1. The average median nerve latency (P = 0.04), mean conduction velocity (P = 0.02), and mean action potential amplitude (P = 0.01) were significantly shorter in patients who underwent effective thymectomy after chemotherapy. Conclusion: Thymus can improve the chemotherapy induced neurotoxicity. Electrophysiological testing may be an objective evaluation of the neurotoxicity of chemotherapy.