CAJ | 학술논문

目的：评估甲钴胺和还原性谷胱甘肽对减少奥沙利铂（L-OHP）引起的神经毒性的作用。方法采用随机、安慰剂对照的方法，将接受含有 L-OHP 和氟尿嘧啶（5-Fu）方案化疗的96例大肠癌患者随机分为对照组、甲钴胺组、还原性谷胱甘肽组，分别同时给予生理盐水、甲钴胺和还原性谷胱甘肽，利用奥沙利铂专用神经毒性分级和神经症状评分（NSS）指标观察患者神经毒性发生率及严重程度。结果对照组、甲钴胺组、还原性谷胱甘肽组急性神经毒性分别：28例（90．3％）、14例（46．7％）、19例（59．4％）。化疗3周期和6周期时，甲钴胺组神经毒性Ⅱ～Ⅲ度发生率显著低于对照组（P ＜0．01，P ＜0．05），而还原性谷胱甘肽组神经毒性Ⅱ～Ⅲ度发生率低于与对照组，但无显著性差异（P ＞0．05），甲钴胺组神经毒性Ⅱ～Ⅲ度发生率低于还原性谷胱甘肽组，但无显著性差异（P ＞0．05）。化疗3周期和6周期时，甲钴胺组 NSS 评分显著均低于对照组和还原性谷胱甘肽组（P ＜0．05或 P ＜0．01），而还原性谷胱甘肽组均与对照组无显著性差异（P ＞0．05）。结论甲钴胺能预防 L-OHP 神经毒性的发生率和程度。
목적：평고갑고알화환원성곡광감태대감소오사리박（L-OHP）인기적신경독성적작용。방법채용수궤、안위제대조적방법，장접수함유 L-OHP 화불뇨밀정（5-Fu）방안화료적96례대장암환자수궤분위대조조、갑고알조、환원성곡광감태조，분별동시급여생리염수、갑고알화환원성곡광감태，이용오사리박전용신경독성분급화신경증상평분（NSS）지표관찰환자신경독성발생솔급엄중정도。결과대조조、갑고알조、환원성곡광감태조급성신경독성분별：28례（90．3％）、14례（46．7％）、19례（59．4％）。화료3주기화6주기시，갑고알조신경독성Ⅱ～Ⅲ도발생솔현저저우대조조（P ＜0．01，P ＜0．05），이환원성곡광감태조신경독성Ⅱ～Ⅲ도발생솔저우여대조조，단무현저성차이（P ＞0．05），갑고알조신경독성Ⅱ～Ⅲ도발생솔저우환원성곡광감태조，단무현저성차이（P ＞0．05）。화료3주기화6주기시，갑고알조 NSS 평분현저균저우대조조화환원성곡광감태조（P ＜0．05혹 P ＜0．01），이환원성곡광감태조균여대조조무현저성차이（P ＞0．05）。결론갑고알능예방 L-OHP 신경독성적발생솔화정도。
Objective To assess the efficacy of mecobalamin and glutathione in preventing the neurotoxicity induced by oxaliplatin (L-OHP).Methods A randomized,placebo and control study was made ,in which 9 6 patients with colorectal cancer received L-OHP and 5-Fluorouracil (5-FU)was randomly divided into control group treated with normal saline,mecobalamin group with mecobalamin and glutathione group with glutathione,respectively,32 cases for each.Rate of neurotoxicity and severity was observed by L-OHP-specific neurotoxicity grading and neurological symptom score (NSS).Results Rates of neurotoxicity in control group,mecobalamin group and glutathione group were 90.3%(28 /32),46.7%(14 /32)and 59.4%(19 /32)respectively.After 3-cycle and 6-cycle chemotherapy,the rate of neurotoxicity in degree Ⅱ~Ⅲ was lower in mecobal-amin group than in other groups,but the differences were not significant (P >0.05),whereas NSS score was obviously lower in mecobalamin group than in other groups (P <0.05,P <0.01),but the difference between control group and glutathione group was not significant (P >0.05).Conclu-sion Mecobalamin can prevent the rate and severity of oxaliplatin-induced neurotoxicity.