神经节苷酯对奥沙利铂化疗后神经损伤预防作用研究

Prophylaxis function of Ganglioside on Oxaliplatin induced nerve injury

目的探讨神经节苷酯（GM1）是否对奥沙利铂引起的神经损伤有预防作用。方法选择2012年1月至2013年12月在我院使用含奥沙利铂方案进行辅助化疗以及标准治疗的胃癌及结肠癌患者140例,研究组（T）与对照组（C）化疗方案均选择FOLFOX方案,研究组给予GM1加入250m L生理盐水静滴,持续10天;对照组仅给予生理盐水250m L对照。结果急性神经损伤均为Ⅰ~Ⅲ级,T组与C组急性神经损伤总发病率83.2%（65/78）与93.5%（58/62）（χ2=3.379,P=0.066）,并且Ⅰ~Ⅲ级神经损伤比率无统计学差异（χ2=1.219,P=0.543）。T组与C组慢性神经损伤总发病率为研究组与对照组分别为34.6%（27/78）与50.7%（37/62）（χ2=8.743,P=0.003）,慢性Ⅰ~Ⅳ级神经损伤两组分别为（T）33.3%,51.9%,11.1%,3.7%与（C）10.8%,45.9%,29.7%,13.5%（χ2=8.086,P=0.044）。结论 GM1可能对奥沙利铂慢性神经毒性有一定预防作用,但对急性损伤似乎并没有作用,最佳给药剂量及进一步药理作用需要进一步研究。

Objectives To detect whether ganglioside （ GM1 ） can prevent oxaliplatin induced nerve injury.Methods Select 140 cases standard or adjuvant chemotherapy patients,the program was FOLFOX（oxaliplatin was included）, patients in the test group（T） were given GM1100mg and 250mL 0.9%NS per day, while patients in the control group（C） were given only 250mL 0.9%NS.Results Acute nerve injury（ ANI） grade wasⅠ~Ⅲ,no grade injury did occur.The incidence of ANI for the T and C group were 83.2%（65/78） and 93.5%（58/62） （χ2 =3.379,P=0.066）.That ANI grade between the two groups showed no sta-tistic difference（χ2 =1.219,P=0.543）.The incidence chronic nerve injury（CNI） in the the two groups were 34.6% （T）and 50.7%（C） （χ2 =8.743,P=0.003）.The grade from Ⅰ~Ⅳof CNI in T group were 33.3%,51.9%,11.1%,3.7%,and that in C group 10.8%,45.9%,29.7%,13.5%（χ2 =8.086,P=0.044）.Conclusions May be GM1 can reduce chronic oxaliplatin in-duced nerve injury, but seem no effect on its acute injury.And the best dose together with Pharmacologic action for GM1 need fur-ther study.