老年胸部恶性肿瘤行调强放疗后动态心电图变化特点及相关因素分析

Analysis of dynamic electrocardiogram characteristics and related factors after intensity-modulated radiotherapy in elderly patients with chest malignant tumor

目的:探讨分析老年胸部恶性肿瘤行调强放疗(IMRT)后动态心电图变化特点及相关因素。方法:选择我院收治并接受调强放疗的老年胸部恶性肿瘤患者81例,在放疗前后行24 h动态心电图监测,统计患者治疗后动态心电图异常情况,并收集整理患者临床、物理资料,采用单因素分析以及多因素分析探讨可能影响患者放疗后动态心电图异常的相关因素。结果:81例老年胸部恶性肿瘤患者,IMRT治疗后发生DCG明显改变45例(55.56%);对可能影响患者IMRT治疗后动态心电图改变的各因素进行分析,经单因素及多因素Logistic回归分析结果显示,性别、年龄、临床分期、心脏V40进入多因素回归模型,为影响老年胸部恶性肿瘤患者IMRT治疗后动态心电图改变的重要因素(P<0.05)。结论:老年胸部恶性肿瘤调强放疗后动态心电图异常发生率较高,女性、高龄、临床分期高、心脏V40是患者治疗后心电图异常的独立危险因素。

Objective： To investigate the changes of dynamic electrocardiogram（ ECG） and related factors after intensity-modulated radiotherapy（ IMRT） in elderly patients with chest malignant tumors. Methods： 81 elderly patients with chest tumor IMRT patients were collected. Before and after radiotherapy,24 h Holter monitoring statistics were collected. After treatment dynamic electrocardiogram abnormalities were monitored,and clinical and physical information of the patients were collected. By single factor analysis and multi-factor analysis,the possible factors associated with abnormal ECG effects patients after radiotherapy were explored. Results： The possible influencing factors of IMRT patients after treatment of dynamic electrocardiogram were analyzed by univariate and multivariate Logistic regression analysis,which showed that gender,age,clinical stage,heart V40 into the multi-factor regression model（ P＜0. 05）.Conclusion： The elderly chest malignant tumor after IMRT dynamic ECG abnormal rate is higher. Female,elderly,well clinical stage,heart V40 were independent risk factors of abnormal ECG after treatment.