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 effect of sodium tanshinone IIA sulfonate on oxaliplatin induced peripheral neurotoxicity. Methods: 36 cases were chemotherapy containing oxaliplatin,randomly divided into tanshinone treatment group and chemotherapy group. Chemotherapy group were recieved chemotherapy containing oxaliplatin 130 mg / m2* d1,repeated every 21 days,on schedule to 4 cycles. Tanshinone treatment group was added with sodium tanshinone IIA sulfonate 80 mg in 5% glucose 500 ml iv during the chemotherapy of oxaliplatin,1 times per day for 3 days. After chemotherapy 4 cycles,peripheral neuropathy degree evaluation were detected before and after treatment in two groups,and the malondialdehyde( MDA) content,superoxide dismutase( SOD) activity,common peroneal nerve conduction velocity of MNCV and SNCV were detected individually. Results: The peripheral neurotoxicity incidence of tanshinone group was 27. 8%,which of chemotherapy group was 55. 6%,there was significant difference between two groups( P 〈 0. 05). The peroneal nerve conduction velocity of tanshinone treatment group was faster than that of the control group,and the content of MDA( 6. 31 ± 2. 74μmol / L) was significantly lower than that of the control group( 11. 66 ± 3. 50μmol / L)( P 〈 0. 05),but the SOD activity of tanshinone therapy group( 79. 51 ± 7. 96 k U / L)was significantly higher than the control group( 42. 24 ± 10. 79 k U / L)( P 〈 0. 05). Conclusion: Sodium tanshinone IIA sulfonate can reduce the occurrence of neurotoxicity of oxaliplatin,probably by starting the antioxidant effect,exert neuroprotective function.