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目的:该研究通过检查铂类药物使用前后神经传导速度变化,观察、比较铂类化疗药物剂量累积引起神经传导速度的变化与临床上的神经毒性分级二者之间的相关性和灵敏性。方法:用肌电图检测45例铂类化疗的肿瘤患者,在化疗前及分别化疗2、4、6个周期后进行外周神经毒性的评价及外周神经电生理检测。结果:2、4、6周期结束后21 d检查,分别有27例、36例、41例患者出现外周神经异常,发生率为60.0%、80.0%、91.1%;分别有14例、21例及28例出现临床症状,发生率分别为31.1%、46.7%、62.2%。6周期化疗,患者自觉神经毒性症状逐渐加重,电生理检查神经传导速度减慢及波幅降低。结论:化疗药物诱导性周围神经病(CIPN)电生理改变与临床神经毒性分级呈正相关性,且电生理异常早于患者自觉症状出现,神经电生理检测能早期发现CIPN。
OBJECTIVE: This study examined the changes of nerve conduction velocity before and after the use of platinum drugs, observed and compared the changes of nerve conduction velocity caused by cumulative doses of platinum chemotherapeutics and the correlation and sensitivity of clinical neurotoxicity grade. Methods: Forty-five patients with platinum-based chemotherapy were examined by electromyography. Peripheral nerve electrophysiology and peripheral nerve electrophysiology were evaluated before and after 2,4,6 cycles of chemotherapy. Results: At 21 days after the end of 2,4,6 cycles, there were 27 cases, 36 cases and 41 cases with peripheral nerve abnormalities. The incidence rates were 60.0%, 80.0% and 91.1% respectively. There were 14 cases, 21 cases and 28 cases of clinical symptoms, the incidence was 31.1%, 46.7%, 62.2%. 6 cycles of chemotherapy, patients with progressive neurological symptoms gradually aggravated, electrophysiological examination of nerve conduction velocity slowed and amplitude decreased. CONCLUSION: The electrophysiological changes induced by chemotherapeutic drug-induced peripheral neuropathy (CIPN) are positively correlated with the grade of clinical neurotoxicity. Electrophysiological abnormalities occur earlier than patients’ symptoms, and CIPN can be found early by electrophysiological examination.