硼替佐米致周围神经病变病人神经生长因子的变化

目的探讨神经生长因子（NGF）在硼替佐米导致的周围神经病变发病机制中的作用及其与运动、感觉神经传导速度（MCV、SCV）变化的关系。方法对10例临床诊断为多发性骨髓瘤（MM）应用硼替佐米为主方案治疗的病人（硼替佐米组）、10例临床诊断为MM应用传统VAD方案化疗的病人（化疗组）,应用酶联免疫吸附法检测其血清NGF水平,并以10例健康人作对照;同时对硼替佐米组病人治疗前后MCV、SCV进行测定。结果硼替佐米组、化疗组治疗前与健康对照组血清NGF水平比较,差异均无统计学意义（P〉0.05）,硼替佐米组、化疗组治疗后血清NGF水平逐渐下降（F=58.269,P〈0.05）,硼替佐米组比化疗组下降更明显（F=5.521,P〈0.05）。硼替佐米组病人血清NGF下降水平与周围神经病变程度呈正相关（r=0.727,P〈0.05）,与疗效呈正相关（r=0.681,P〈0.05）,与治疗前后各神经MCV、SCV变化值均无相关性（P〉0.05）。硼替佐米组病人治疗前后肌电图无明显差异（P〉0.05）。结论 NGF合成减少在硼替佐米导致周围神经病变的发病机制中起一定作用。

DIVERSITY OF NERVE GROWTH FACTOR IN PATIENTS WITH BORTEZOMIB-INDUCED PERIPHERAL NEUROPATHY

Objective To explore the action of nerve growth factor（NGF）in the pathogenesis of bortezomib-induced peripheral neuropathy（BIPN）and its relationship with the changes of motor conduction velocity（MCV）and sensory conduction velocity（SCV）. Methods Serum levels of NGF in multiple myeloma（MM）patients were detected by enzyme-linked immunosorbent assay in 10treated with bortezomib（bortezomib group）,and 10treated with conventional VAD,respectively,and 10healthy individuals served as controls.The MCV and SCV in patients of bortezomib group were detected before and after therapy. Results Before therapy,the serum levels of NGF between bortezomib group,VAD group and control group were not statistically different（P〈0.05）.After therapy,the NGF levels in bortezomib and VAD groups declined gradually（F=58.269,P〈0.05）,more obviously declined was noted in bortezomib group（F=5.521,P〈0.05）.The decrease of serum NGF in bortezomib group was positively correlated with BIPN（r=0.727,P〈0.05）and therapeutic effect（r=0.681,P〈0.05）,and not correlated with MCV and SCV,before and after therapy（P〉0.05）.The electromyogram of patients in bortezomib group,before and after treatment,showed no significant difference（P〈0.05）. Conclusion The decrease of synthesis of serum nerve growth factor plays a certain role in pathogenesis of bortezomib-induced peripheral neuropathy.