【恶性肿瘤患者化疗毒性作用引起的神经性疼痛】。

S V Chubykina, M U Tatarinova, G G Avakyan
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引用次数: 0

摘要

本文讨论了化疗引起的周围神经性疼痛(CIPNP)及其相关的神经性疼痛综合征,发生在恶性肿瘤(MN)患者在细胞抑制剂治疗期间。根据各种来源估计,在与神经毒性药物化疗相关的恶性肿瘤患者中,CIPNP的总体患病率约为70%。CIPNP的病理生理机制尚未得到充分研究,但已知其基于:轴突转运受损、氧化应激、细胞凋亡诱导、DNA损伤、电压门控离子通道功能障碍和中枢机制。在接受细胞抑制剂治疗的癌症患者的临床症状中认识到CIPNP是很重要的,因为这些疾病会导致上肢和下肢运动、感觉和自主神经功能的严重限制,并降低患者的生活质量和日常功能,迫使他们调整化疗药物的剂量,转移下一个周期,甚至中断根据生命需要进行的癌症治疗。除了临床检查外,还开发了量表和问卷来识别CIPNP的症状,但最重要的是神经学和肿瘤学专家要知道并能够识别患者的这些症状。识别多神经病变症状的强制性研究方法包括神经肌电图(ENMG),它允许您评估肌肉活动,功能特征和周围神经功能状态。用于减轻症状的方法是筛查发生CIPNP的患者,识别发生CIPNP的高风险患者,必要时减少剂量或改变细胞抑制剂。使用不同类别的药物纠正这种疾病的方法需要更详细的研究和进一步的研究。
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[Neuropathic pain caused by the toxic effect of chemotherapy in patients with malignant neoplasms].

This article discusses chemotherapy-induced peripheral neuropathic pain (CIPNP) and its associated neuropathic pain syndrome that occurs in patients with malignant neoplasms (MN) during cytostatic therapy. The overall prevalence of CIPNP in patients with malignant neoplasms associated with chemotherapy with neurotoxic drugs is estimated, according to various sources, to be about 70%. The pathophysiological mechanisms of CIPNP have not been fully studied, but it is known that they are based on: impaired axonal transport, oxidative stress, induction of apoptosis, DNA damage, dysfunction of voltage-gated ion channels, and central mechanisms. It is important to recognize CIPNP in the clinical symptoms of patients with cancer treated with cytostatics, since these disorders can lead to serious restrictions in the motor, sensory and autonomic functions of the upper and lower extremities, as well as reduce the quality of life and daily functioning of such patients, forcing them to adjust the dose of chemotherapy drugs, transfer the next cycles and even interrupt the treatment of cancer carried out according to vital needs. In addition to the clinical examination, scales and questionnaires have been developed to identify symptoms of CIPNP, but it is most important for neurological and oncological specialists to know and be able to recognize such symptoms in patients. The mandatory research methods for identifying the symptoms of polyneuropathy include electroneuromyography (ENMG), which allows you to assess muscle activity, functional characteristics and the state of the function of peripheral nerves. The methods used to reduce symptoms are screening patients for the development of CIPNP and identifying patients at high risk of CIPNP and, if necessary, reducing the dose or changing cytostatics. Methods for correcting this disorder using different classes of drugs require more detailed study and further research.

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来源期刊
Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova
Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova Medicine-Psychiatry and Mental Health
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