甲钴胺对结直肠癌患者XELOX方案引起的外周神经病变的预防作用研究

Preventive Effect of Mecobalamin on Peripheral Neuropathy Induced by XELOX Regimen in Patients with Colorectal Cancer

目的:探讨甲钴胺对结直肠癌患者奥沙利铂+卡培他滨(XELOX)方案引起的外周神经病变(CIPN)的预防作用。方法:选取2020年1月至2022年1月广州医科大学附属第四医院收治的76例结直肠癌患者,根据随机数表法分为观察组、对照组,各38例。对照组以XELOX方案治疗,观察组以甲钴胺联合XELOX方案治疗。经过6个化疗周期后,评估比较组间患者的CIPN发生率、神经传导速度、血清学指标、生活质量评分、不良反应发生率。结果:观察组CIPN为Ⅱ级、Ⅲ级、Ⅳ级的发生率均低于对照组(P<0.05)。治疗后观察组正中、腓肠神经的运动神经传导速度(MNCV)、感觉神经传导速度(SNCV)高于对照组(P<0.05)。观察组Nod样受体蛋白3(NLRP3)、缺氧诱导因子-1α(HIF-1α)、B细胞活化因子受体(BAFF-R)水平均低于对照组(P<0.05)。观察组欧洲癌症治疗研究组织生命质量测定量表(EORTC QLQ-C30)各项评分均高于对照组(P<0.05)。治疗期间观察组不良反应发生率为15.79%(6/38),对照组为10.53%(4/38),差异无统计学意义(P>0.05)。结论:甲钴胺对结直肠癌患者XELOX方案引起的CIPN有显著的预防作用,能够降低CIPN发生率,提高患者周围神经传导速度,抑制相关炎症因子水平,改善患者的生活质量,有较高的临床应用价值。

Objective:To study the preventive effect of mecobalamin on peripheral neuropathy(CIPN)induced by oxaliplatin+capecitabine(XELOX)regimen in patients with colorectal cancer.Methods:A total of 76 patients with colorectal cancer who were admitted to the Fourth Affiliated Hospital of Guangzhou Medical University from January 2020 to January 2022 were selected and divided into observation group and control group according to the random number table method,with 38 cases in each group.The control group was treated with XELOX regimen,and the observation group was treated with Mecobalamin Combined with XELOX regimen.After six chemotherapy cycles,the incidence of CIPN,nerve conduction velocity,level of inflammatory factors and incidence of adverse reactions were evaluated and compared among the groups.Results:The incidence of CIPN of grade II,III and IV in the observation group was lower than that in the control group(P<0.05).After treatment,the SNCV,MNCV of the median nerve and sural nerve in the observation group were higher than those in the control group(P<0.05).The levels of Nod-like receptor protein 3(NLRP3),hypoxia-inducible factor-1α(HIF-1α)and B cell activating factor receptor(BAFF-R)in the observation group were lower than those in the control group(P<0.05).The scores of European Organization for Research and Treatment of Cancer Quality of Life Questionnaire(EORTC QLQ-C30)in the observation group were higher than those in the control group(P<0.05).During the treatment,the incidence of adverse reactions was 15.79%(6/38)in the observation group and 10.53%(4/38)in the control group,with no significant difference(P>0.05).Conclusion:Mecobalamin has a significant preventive effect on CIPN of XELOX regimen in patients with colorectal cancer.It can reduce the incidence of CIPN,and it can improve peripheral nerve conduction velocity,and it can inhibit the level of related inflammatory factors,and it can improve the quality of life of patients,and it has high clinical value.