心电图肌电图对化疗药的心脏和神经毒性价值研究

Value of electrocardiogram and electromyography in cardiotoxicity and neurotoxicity induced by chemotherapy drugs

目的探讨人体实体性肿瘤化疗前后心电图和肌电图的变化,以评估化疗药物对患者心脏和神经的毒性作用.方法共纳入本院确诊的乳腺癌、肺癌、结肠癌、卵巢癌患者共80例,患者均进行了术后化疗,其中化疗方案为蒽环类的46例,非蒽环类34例,化疗前后均用心电图机(日本光电1550p)和肌电图诱发电位仪(维迪keypoint)对实验对象进行相关指标检测,对比其差异性.结果蒽环类化疗药物的心电图异常率为41.30%,明显高于非蒽环类药物(13.24%),差异有统计学意义(P<0.05);其中最主要表现为Q-T间期延长.与化疗前比较,全部窦性RR间期标准差以及均方根均有所降低,且在蒽环类药物组中上述表现尤为明显(P<0.05).含铂类药物与未含铂类药物治疗后运动神经传导速度和感觉神经传导速度总异常率分别为58.82%和17.39%.结论铂类药物化疗后容易引起诱发周围神经疾病,而蒽环类类化疗药物对心脏的毒性较大,引起的心电图异常尤为明显,联合检测心电图和肌电图对早期预防化疗药物的毒性作用具有重要意义.

Objective To investigate the value of electrocardiogram and electromyography in cardiotoxicity and neurotoxicity induced by chemotherapy drugs.Methods A total of 80 cases of breast cancer,lung cancer,colon cancer,and ovarian cancer diagnosed in our hospital were included.All the patients underwent postoperative chemotherapy.Among them,46 cases received chemotherapy with anthracycline,and 34 cases with non-anthracycline.Before and after chemotherapy,electrocardiograph(ECG)and electromyographic induction potentiometer(EMG)were used to detect the related indicators of the patients.Results The abnormal rate of electrocardiogram induced by anthracycline chemotherapy was 41.30%,which was significantly higher than that of non-anthracycline drugs(13.24%),with a statistical difference(P<0.05).The most important manifestation was the prolongation of Q-T interval.Compared with those before treatment,the standard deviation and RMS of all sinus RR interphase significantly decreased,especially in the anthracycline group(P<0.05).The total abnormal rates of motor nerve conduction velocity and sensory nerve conduction velocity after chemotherapy were 58.82%and 17.39%in the patients taking platinum-containing chemotherapy.Conclusion Platinum-containing drugs are prone to induce peripheral nerve diseases after chemotherapy,while anthracycline chemotherapy drugs are relatively toxic to heart,and the electrocardiogram abnormalities caused by them are particularly obvious.The combination of electrocardiogram and electromyography is of great significance for early prevention of toxic effects caused by chemotherapy drugs.