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目的:观察丹参酮IIA磺酸钠注射液对奥沙利铂诱导的外周神经毒性的防治作用。方法:入选36例病例均为含有奥沙利铂的化疗方案,随机平分为丹参酮治疗组和化疗组。化疗组均接受含有奥沙利铂130mg/m2*d1的化疗方案,每21天重复一次,按期化疗4周期。丹参酮治疗组在用奥沙利铂前加用丹参酮IIA磺酸钠80mg加入5%葡萄糖液500ml中静脉滴注,每天1次,连用3天。完成4个周期后评价外周神经病变程度,并分别检测两组治疗前后丙二醛(MDA)含量、超氧化物歧化酶(SOD)活性、腓总神经传导速度MNCV和SNCV。结果:其中丹参酮治疗组外周神经毒性发生率27.8%,化疗组外周毒性总发生率55.6%,两组差异有显著性。化疗后丹参酮治疗组腓总神经传导速度明显增快,MDA含量(6.31±2.74μmol/L)显著低于对照组(11.66±3.50μmol/L),而丹参酮治疗组SOD活性(79.51±7.96k U/L)明显高于对照组(42.24±10.79 k U/L)。结论:丹参酮IIA磺酸钠能降低奥沙利铂神经毒性的发生,可能是通过启动抗氧化作用,发挥神经保护功能。
Objective: To observe the preventive and therapeutic effects of sodium tanshinone IIA sulfonate on peripheral neurotoxicity induced by oxaliplatin. Methods: Thirty-six cases were enrolled in the chemotherapy regimen containing oxaliplatin and randomly divided into tanshinone group and chemotherapy group. Chemotherapy group received chemotherapy containing oxaliplatin 130mg / m2 * d1, repeated every 21 days, scheduled for 4 cycles of chemotherapy. Tanshinone treatment group with oxaliplatin before adding tanshinone IIA sulfonate 80mg added 5% glucose solution 500ml intravenous infusion, once daily for 3 days. Peripheral neuropathies were evaluated after 4 cycles were completed. Malondialdehyde (MDA) content, superoxide dismutase (SOD) activity, peroneal nerve conduction velocity MNCV and SNCV were measured before and after treatment. Results: The incidence of peripheral neurotoxicity was 27.8% in tanshinone group and 55.6% in chemotherapy group. There was significant difference between the two groups. Tanshinone group had significantly higher peroneal nerve conduction velocity (6.31 ± 2.74μmol / L) than that of the control group (11.66 ± 3.50μmol / L), while the tanshinone treatment group had a higher SOD activity (79.51 ± 7.96kU / L) was significantly higher than the control group (42.24 ± 10.79 kU / L). CONCLUSION: Sodium tanshinone IIA sulfonate can reduce the neurotoxicity of oxaliplatin, which may play a neuroprotective role by initiating anti-oxidant effect.