目的 系統(tǒng)評價(jià)化療藥物所致周圍神經(jīng)病變（chemotherapy-induced peripheral neuropathy，CIPN）的發(fā)生風(fēng)險(xiǎn)與糖尿病的相關(guān)性。方法 檢索Embase、PubMed、Web of Science、中國學(xué)術(shù)期刊全文數(shù)據(jù)庫（CNKI）、萬方數(shù)據(jù)庫中關(guān)于CIPN的發(fā)生風(fēng)險(xiǎn)與糖尿病相關(guān)性的隊(duì)列和病例對照研究，檢索時(shí)限為建庫—2017年12月31日，采用Stata 11.0軟件對符合標(biāo)準(zhǔn)的研究進(jìn)行Meta-分析。結(jié)果 共納入15篇文獻(xiàn)，16項(xiàng)研究，3 541例患者。Meta-分析結(jié)果顯示：糖尿病腫瘤患者發(fā)生CIPN的風(fēng)險(xiǎn)高于非糖尿病腫瘤患者（OR=1.65，95%CI=1.33~2.05，P=0.000）。亞組分析顯示，無論在亞洲地區(qū)（OR=1.65，95%CI=1.28~2.12，P=0.000）還是非亞洲地區(qū)（OR=1.65，95%CI=1.08~2.53，P=0.020），CIPN的發(fā)生風(fēng)險(xiǎn)都與糖尿病相關(guān)。使用紫杉類藥物化療的腫瘤患者發(fā)生CIPN的風(fēng)險(xiǎn)與糖尿病顯著相關(guān)（OR=1.72，95%CI=1.32~2.24，P=0.000），而使用奧沙利鉑化療的腫瘤患者發(fā)生CIPN的風(fēng)險(xiǎn)與糖尿病無明顯相關(guān)性（OR=1.31，95%CI=0.83~2.05，P=0.242）。結(jié)論 CIPN的發(fā)生風(fēng)險(xiǎn)與糖尿病密切相關(guān)，糖尿病可以增加CIPN的發(fā)生風(fēng)險(xiǎn)。受納入研究數(shù)量及質(zhì)量的限制，該結(jié)論還需大規(guī)模、高質(zhì)量的研究予以證實(shí)。

Objective To systematically evaluate the relevance of the risk of chemotherapy-induced peripheral neuropathy (CIPN) and diabetes. Methords Embase, PubMed, Web of Science, CNKI and WanFang databases were searched for cohort and casecontrol studies about the relevance of the risk of CIPN and diabetes from inception to December 31, 2017. Stata11.0 software was used to perform Meta-analysis of the eligible studies. Results A total of 15 articles, 16 studies, and 3 541 patients were included. Meta-analysis showed that the risk of CIPN was higher in cancer patients with diabetes than in those without diabetes (OR=1.65, 95%CI=1.33-2.05, P=0.000). Subgroup analysis showed that the risk of CIPN was related to diabetes whether in Asian region (OR=1.65, 95%CI=1.28-2.12, P=0.000) or non-Asian region (OR=1.65, 95%CI=1.08-2.53, P=0.020). The risk of CIPN was significantly associated with diabetes in cancer patients who were treated with taxanes (OR=1.72, 95%CI=1.32-2.24, P=0.000). However, the risk of CIPN was not significantly associated with diabetes in cancer patients who were treated with Oxaliplatin (OR=1.31, 95%CI=0.83-2.05, P=0.242). Conclusions The risk of CIPN is closely related to diabetes which increases the risk of CIPN. Due to the limitation of quantity and quality of included studies, the conclusion needs to be confirmed by large-scale and high-quality researches.

遼寧省科學(xué)技術(shù)計(jì)劃項(xiàng)目（2012225107）