胸部肿瘤放化疗致心电学指标改变的研究

A clinical study of the indexes of electrocardiologe of heart injury-induced by chemoradiotherapy for the thoracic tumor

目的通过对胸部肿瘤患者单纯放疗、序贯放化疗和同步放化疗进行常规心电图和动态心电图监测,分析心脏损伤的早期心电图改变。方法胸部肿瘤单纯放疗、序贯和同步放化疗的患者60例,均在治疗前、中、后进行常规心电图及动态心电图监测。结果常规心电图的各项心电学指标在治疗前、中、后比较差异无统计学意义(P>0.05);动态心电图中室上性心律失常改变在治疗前、中、后比较差异有统计学意义(P<0.05),ST-T改变在治疗中和治疗后比较差异有统计学意义(P<0.05)。结论心电学指标是早期发现心脏放射性损伤的敏感方法之一,尤其通过无创便捷的动态心电图检查,更有利于早期发现胸部肿瘤患者的心脏放射性损伤。

Objective To determine the early changes in electrocardiogram of the heart injury-induced by simple radiotherapy and sequential chemoradiotherapy and concurrent chemoradiotherapy for the thoracic tumor. Methods patients with stage Ⅰ-Ⅲ tho-racic tumor randomised to receive simple radiotherapy, sequential chemoradiotherapy and concurrent chemoradiotherapy, Electrocardiogram （ECG） and Holter monitoring were used to evaluate the heart injury before, during and after different therapy methods. Resuits The index of electrocardiologe of ECG showed no difference between 3 therapy groups before,during and after therapy （P〉 0.05）. Holter monitoring revealed that the frequency of supraventricular tachycardia （SVT） was different among the different stage of therapy （before, during and after therapy） in different therapy （P〈0.05） ;there was significant difference between 2 therapy stages （during and after therapy） （P〈0.05）. Conclusion the indexes of electrocardiologe are sensitive methods for detect the radiation-induced heart injury.