化疗期间心电图异常对蒽环类药物引起乳腺浸润性导管癌患者慢性心脏毒性的预测价值

Value of Electrocardiogram Abnormalities in Predicting Chronic Cardiotoxicity Induced by Anthracycline Chemotherapy in Invasive Breast Ductal Carcinoma Patients

目的研究化疗期间心电图异常对蒽环类药物引起乳腺浸润性导管癌患者慢性心脏毒性的预测价值。方法收集郑州大学第二附属医院乳腺外科2013年5月—2015年5月收治的经病理检查确诊为乳腺浸润性导管癌患者123例。根据随访期间是否发生心脏毒性分为心脏毒性组21例和无心脏毒性组102例。观察两组心电图检查结果,分析乳腺浸润性导管癌化疗后发生慢性心脏毒性的影响因素。结果两组年龄比较,差异有统计学意义(P<0.05);心脏毒性组心电图异常、ST-T段改变、T波异常发生率高于非心脏毒性组(P<0.05);心脏毒性组心电图异常次数多于非心脏毒性组(P<0.05)。多因素Logistic回归分析显示,年龄、心电图异常次数、ST-T段改变、T波异常是乳腺浸润性导管癌化疗后慢性心脏毒性的影响因素(P<0.05)。结论女性乳腺浸润性导管癌的年龄、化疗期间心电图异常与慢性心脏毒性发生有一定相关性,对早期预防和治疗化疗引起的慢性心脏毒性有重要的临床指导意义。

Objective To investigate the value of electrocardiogram （ECG） abnormalities in predicting chronic cardiotoxicity induced by anthracycline chemotherapy in invasive breast ductal carcinoma patients. Methods This study enrolled 123 consecutive patients, who were admitted to Department of Breast Surgery of the Second Affiliated Hospital of Zhengzhou University from May 2013 to May 2015 and diagnosed with invasive breast ductal carcinoma confirmed pathologically. According to cardiotoxicity during follow - up, they were divided into cardioxicity group （ n = 21 ） and non - cardioxicity group （ n = 102）. The ECG consequence between the two groups were observed, the influnce factor of chronic cardiotoxicity occured after chemotherapy of invasive breast ductal carcinoma patients. Results Significant difference in age was found between the two groups （ P 〈0. 05 ）. Compared with the non - cardioxicity group, the cardioxicity group had a higher percentage of ECG, ST - T segment and T - wave abnormalities during chemotherapy （ P 〈 0. 05 ） . ECG abnormalities occurred more frequently in the cardioxicity group than in the non - cardioxicity group （ P 〈 0. 05 ） . Multivariate Logistic regression analysis found that age, frequency of ECG abnormalities, ST - T segment and T - wave abnormalities were correlation factors for chronic cardioxicity in invasive breast ductal carcinoma after chemotherapy （ P 〈 0.05 ） . Conclusion Age and ECG abnormalities occurred during anthracycline chemotherapy, have a clear relationship with the chronic cardioxicity in women with invasive breast ductal carcinoma. This has tremendous clinical significance in the early prevention and treatment of chronic cardioxicity due to chemotherapy.