动态心电图在FOLFOX6方案治疗结直肠癌患者化疗相关心脏毒性监测中的应用

Application of Ambulatory Electrocardiogram in Monitoring Chemotherapy-Related Cardiotoxicity in Colorectal Cancer Patients Treated with FOLFOX6 Regimen

目的探讨动态心电图在FOLFOX6方案治疗结直肠癌(CRC)患者化疗相关心脏毒性监测中的应用效果。方法选取5个肿瘤中心(广西医科大学附属柳铁中心医院肿瘤科、广西科技大学第一附属医院肿瘤科、融水苗族自治县人民医院肿瘤科、平南县第二人民医院肿瘤科和广西科技大学第二附属医院肿瘤科)2015年7月至2018年6月接诊的、同意使用FOLFOX6方案化疗的中晚期结直肠癌患者154例作为研究对象,每周期化疗前后,所有患者均分别使用动态心电图及常规心电图监测化疗相关心脏毒性,比较两种方法的检出情况。结果动态心电图对化疗相关心脏毒性的检出率高于常规心电图,差异有统计学意义(P<0.05);两种方法对化疗相关心脏毒性严重程度的检出情况比较,差异有统计学意义(P<0.05);动态心电图对心律失常、ST-T改变的检出率高于常规心电图,差异有统计学意义(P<0.05)。结论FOLFOX6方案治疗中晚期CRC患者所致的化疗相关心脏毒性以轻度为主,动态心电图的检测灵敏度高于常规心电图,更利于检出化疗相关心脏毒性。

Objective The application effect of ambulatory electrocardiography in monitoring chemotherapy-related cardiotoxicity in colorectal cancer(CRC)patients treated with FOLFOX6 regimen was investigated.Methods From July 2015 to June 2018,a total of 154 medium term and advanced CRC patients admitted to 5 cancer centers(Oncology Department of The Affiliated Liutie Center Hospital of Guangxi Medical University,Oncology Department of The First Affiliated Hospital of Guangxi University of Science and Technology,Oncology Department of Rongshui Miao Autonomous County People’s Hospital,Oncology Department of The Second People’s Hospital of Pingnan County and Oncology Department of The Second Affiliated Hospital of Guangxi University of Science and Technology)and agreed to use FOLFOX6 chemotherapy were selected as the research subjects.Before and after each cycle of chemotherapy,all patients were monitored for chemotherapy-related cardiotoxicity by ambulatory electrocardiogram and conventional electrocardiogram.The detection results of the two methods were compared.Results The detection rate of chemotherapy-related cardiotoxicity by ambulatory electrocardiogram was higher than that of conventional electrocardiogram,and the difference was statistically significant(P<0.05);When the detection results about the severity degree of the two methods were compared,the difference was statistically significant(P<0.05);The detection rates of arrhythmia and ST-T changes by ambulatory electrocardiogram were both higher than those of conventional electrocardiogram,and the differences were statistically significant(P<0.05).Conclusions The chemotherapy-related cardiotoxicity of FOLFOX6 regimen used in the medium term and advanced CRC patients is mainly mild.The detection sensitivity of ambulatory electrocardiogram is higher than that of conventional electrocardiogram,which is more conducive to the detection of chemotherapy-related cardiotoxicity.