高压氧联合维生素B12治疗硼替佐米引起周围神经病变临床研究.docVIP

高压氧联合维生素B12治疗硼替佐米引起周围神经病变临床研究 　　【摘要】 目的：研究高压氧联合维生素B12治疗硼替佐米引起的周围神经病变的临床效果。方法：选取确诊为多发性骨髓瘤的患者予以硼替佐米治疗后出现周围神经病变，随机将患者分为高压氧联合维生素B12的治疗组及单用维生素B12的对照组，每组23例。结果：治疗组总有效率为82.60%，对照组总有效率为56.52%，两组比较差异有统计学意义（P0.01）。两组神经传导速度改善与治疗前比较差异均有统计学意义（P0.01）；治疗组改善更明显，治疗组的腓总神经、正中神经、胫神经的传导速度均明显改善，与对照组比较差异均有统计学意义（P0.01）。结论：高压氧联合维生素B12能有效缓解硼替佐米引起的多发性骨髓瘤患者的周围神经病变，为有效、安全的神经保护方案。 　　【关键词】 高压氧； 硼替佐米； 多发性骨髓瘤； 周围神经病变 　　中图分类号 R745 文献标识码 A 文章编号 1674-6805（2016）9-0007-03 　　【Abstract】 Objective：To study the clinical effect of of hyperbaric oxygen combined with Vitamin B12 in the treatment of peripheral neuropathy induced by Bortezomib.Method：The patients with multiple myeloma which treated with Bortezomib，the peripheral neuropathy appeared after treatment，they were randomly divided into the treatment group（hyperbaric oxygen combined with Vitamin B12） and the control group（single use of Vitamin B12），each group had 23 cases.Result：The total effective rate was 82.60% in the treatment group and 56.52% in the control group，there was significant difference between the two groups（P0.01）.After treatment，the improvement of nerve conduction velocity in the two groups were statistically significant than before treatment（P0.01）；the treatment group improved more significantly，the conduction velocity of the common nerve，median nerve and tibial nerve in the treatment group were significantly improved than those in the control group（P0.01）.Conclusion：Hyperbaric oxygen combined with Vitamin B12 combined therapy is effective in relieving bortezomib induced multiple bone in multiple myeloma patients with peripheral neuropathy，is a safe and effective neuroprotective regimen. 　　【Key words】 Hyperbaric oxygen； Bortezomib； Multiple myeloma； Peripheral neuropathy 　　First-author’s address：Yantaishan Hospital in Yantai City，Yantai 264001，China 　　doi：10.14033/j.cnki.cfmr.2016.9.004 　　多发性骨髓瘤（multiple myeloma，MM）为浆细胞恶性增殖的老年性不可治愈的肿瘤，居血液系统恶性肿瘤的第2位，占10%～15%，随着人口的老龄化，其发病率呈逐年增高的趋势。蛋白酶体抑制剂硼替佐米是对初发及复发难治性骨髓瘤均有较好疗效的药物。周围神经病变（periphe