Q-T间期离散度在表阿霉素心肌损伤中的早期预测价值

The Predictive Value of QT Interval Dispersion in Early Myocardium Injury Induced by Epidoxorubicina

目的:探讨Q-T间期离散度(Q-T cd)在表阿霉素引起的心肌损伤中的早期预测价值。方法:入选29例乳腺癌患者,且均采用含表阿霉素的方案化疗,使用剂量为(75mg/m2),进行2-6个周期,随化疗进行体内表阿霉素累积剂量不同,动态监测心电图Q-T间期离散度的变化,进行分析与评价。结果:各疗程化疗后Q-T间期离散度较化疗前均明显延长,差异有统计学意义,P<0.05。其中第2疗程、第3疗程化疗结束后Q-T间期离散度延长最为明显,P<0.001,第1疗程、第4疗程化疗结束后Q-T间期离散度延长较为明显,P<0.01,第5疗程化疗结束后Q-T间期离散度轻度延长,P<0.05。结论:心电图Q-T间期离散度在表阿霉素引起的心肌损伤中具有早期预测价值,且与损伤心肌病灶的大小成正比,通过监测心电图Q-T间期离散度变化能够在心肌损伤亚临床阶段发现其心脏毒性的发生与进展,能够反应心肌损伤的发生与修复状态。

Objective：To discuss the predictive value of QT interval dispersion in early myocardium in-jury induced by epidoxorubicina .Method： Selected 29 patients with mammary cancer , They accepted the chemotherapy with epidoxorubicina ,The dose of epidoxorubicina was 75mg/m2 , carried out 2-6 cycles.With the different dose of epidoxorubicina in vivo accumulated by chemotherapy , and then analysed and evaluated the change of QT interval dispersion with the different dose of epidoxorubicina be used .Results：Upon com-paring the Q-T interval dispersion before and after chemotherapy , the Q-T interval dispersion become lon-ger, and there was difference compared with before chemotherapy （P＆lt;0.05）.After the first and the fourth cy-cles, the Q-T interval dispersion become longer striking （ P＆lt;0.01） .After the seconed and the third cycles , the Q-T interval dispersion become longer more striking （P＆lt;0.001）.After the fifth cycles, the Q-T interval dispersion become longer slightly （ P＆lt;0.05） .Conclusion：The Q-T interval dispersion can be a useful mark-er for early prediction of epidoxorubicina induced myocardium injury ,and it proportional to the size of myo-cardial injury .We can discover the occurrence and progress of cardiac toxicity in subclinical stage through monitoring the Q-T dispersion changes early , can reflect the occurrence of myocardial injury and repair sta-tus.