中国神经再生研究(英文版)

中国神经再生研究(英文版) ›› 2015, Vol. 10 ›› Issue (5): 814-818.doi: 10.4103/1673-5374.156988

• 原著:周围神经损伤修复保护与再生 • 上一篇    下一篇

沙利度胺治疗强直性脊柱炎：剂量增加会增加并发周围神经病变的危险？

  

  • 收稿日期:2015-03-06 出版日期:2015-05-15 发布日期:2015-05-15

High-dose thalidomide increases the risk of peripheral neuropathy in the treatment of ankylosing spondylitis

Hong-xia Xue 1, Wen-yi Fu 1, Hua-dong Cui 1, Li-li Yang 1, Ning Zhang 1, Li-juan Zhao 2   

  1. 1 Department of Rheumatology and Immunology, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, China
    2 Department of Rheumatology and Immunology, the First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, China
  • Received:2015-03-06 Online:2015-05-15 Published:2015-05-15
  • Contact: Li-juan Zhao or Ning Zhang,zhaolijuan@126.com or zhangning@sj-hospital.org.

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摘要：

沙利度胺作为治疗强直性脊柱炎的药物表现出了较好的疗效，但治疗中偶出现周围神经病变作为该药物的主要不良反应，一直备受关注。我们观察了沙利度胺治疗强直性脊柱炎1年过程中周围神经病变的发生情况。纳入207例应用沙利度胺治疗的强直性脊柱炎患者及未应用沙利度胺的116例强直性脊柱炎患者，发现沙利度胺治疗组周围神经病变发生率高于未用沙利度胺组；用药时间＜6个月组及用药时间≥ 6个月组周围神经病变发生率差异无显著性意义。两组平均年龄、性别构成、及每日剂量都无显著差异；每日沙利度胺给药剂量25，50，75，100 mg/d患者的周围神经病变发生率分别为4.6%，8.5%，17.1%，21.7%，其中25 mg/d组与100 mg/d的发生率差异有显著性意义。结果证实，沙利度胺治疗强直性脊柱炎1年内可出现周围神经病变，年龄、性别对周围神经病变的发生率无显著影响。周围神经病变的发生率可能随着每日剂量的增加而增加。

关键词: 神经再生, 周围神经损伤, 沙利度胺, 强直性脊柱炎, 周围神经病变, 不良反应, 前瞻性研究, 治疗, 剂量, 用药时间, 年龄, 性别

Abstract:

Thalidomide is an effective drug for the treatment of ankylosing spondylitis but might induce peripheral neuropathy. This major adverse reaction has attracted much concern. The current study aimed to observe the incidence of thalidomide-induced peripheral neuropathy among ankylosing spondylitis patients for 1 year after treatment. In this study, 207 ankylosing spondylitis cases received thalidomide treatment, while 116 ankylosing spondylitis cases received other treatments. Results showed that the incidence of thalidomide-induced peripheral neuropathy in the thalidomide group was higher than that in the non-thalidomide group. There was no significant difference in the incidence of neuropathy between the < 6 months medication and ≥ 6 months medication groups. There were no differences in the mean age, gender, or daily dose between the two groups. The incidence of peripheral neuropathy among patients receiving 25, 50, 75, or 100 mg thalidomide per day was 4.6%, 8.5%, 17.1%, 21.7%, respectively. The incidence was significantly different between the groups receiving 25 mg and 100 mg thalidomide. In conclusion, thalidomide can induce peripheral neuropathy within 1 year after treatment of ankylosing spondylitis; however, age and gender have no obvious impact on the incidence of peripheral neuropathy. The incidence of peripheral neuropathy is associated with increasing daily doses of thalidomide.