奥沙利铂致周围神经病变的研究进展

doi:10.16138/j.1673-6087.2025.05.09

摘要/Abstract

摘要：

奥沙利铂诱导的周围神经病变（oxaliplatin-induced peripheral neuropathy，OIPN）是结直肠癌、胃癌等消化道肿瘤化疗中常见的剂量限制性不良反应，其所致感觉异常、疼痛等症状显著影响化疗效果及患者生活质量。本文通过系统综述OIPN的病理机制、诊断依据、影响因素及治疗策略，旨在提高临床工作者对OIPN的重视程度，并为该领域未来的临床管理提供参考依据。

关键词: 周围神经病变, 奥沙利铂, 发病机制, 症状管理

Abstract:

Oxaliplatin-induced peripheral neuropathy (OIPN) is a common dose-limiting toxic reaction in chemotherapy for gastrointestinal malignancies such as colorectal and gastric cancers, is characterized by sensory abnormalities and pain that substantially impair treatment efficacy and quality of life. This article provides a systematic review of the pathogenesis, diagnostic criteria, contributing factors, and therapeutic strategies of OIPN, aiming to raise clinician’s attention to OIPN and provide a reference for future clinical management in oncological practice.

Key words: Peripheral neuropathy, Oxaliplatin, Pathogenesis, Symptom management

中图分类号:

R746

张怡, 仇晓霞. 奥沙利铂致周围神经病变的研究进展[J]. 内科理论与实践, 2025, 20(05): 393-398.

ZHANG Yi, QIU Xiaoxia. Research progress on oxaliplatin-induced peripheral neuropathy[J]. Journal of Internal Medicine Concepts & Practice, 2025, 20(05): 393-398.

图/表 1

参考文献 28

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特性	急性OIPN	慢性OIPN
发生率	4%~95%	30%~50%
时间窗	通常在输注几小时内出现，持续数天	常于累积剂量达540 mg/m²后发生，持续数月或数年
关键分子机制	钠、钾离子通道功能异常；瞬时受体电位通道异常；有机阳离子转运蛋白过表达	核DNA损伤；线粒体功能障碍；氧化应激与神经炎症；胶质细胞激活；肠道菌群失调
典型症状	寒冷诱发的感觉异常（如手脚或口周刺痛）；肌肉痉挛；咽部感觉不良	持续性感觉减退或异常（如麻木、套袜感）；神经性疼痛（灼烧、电击感）；感觉性共济失调（如平衡障碍）