泰索帝联合阿霉素治疗乳腺癌对心电图的影响

Clinical observation of electrocardiographic changes in response to taxotere combined with adriamycin treatment for breast cancer

目的探讨化疗药物泰索帝(taxotere)联合阿霉素一线治疗局部晚期或转移性乳腺癌对心电图的影响,并分析其临床意义。方法被确诊为局部晚期或转移性乳腺癌的250例患者,经静脉滴注泰索帝75 mg/m2和阿霉素5 mg/m2,每3周1次,每个疗程开始前和结束后各观测心电图1次,共动态观察10个疗程。结果10个疗程结束后,250例患者中心率加快8 例(3.2%),肢体导联QRS波低电压12 例(4.8%),Q-T时间延长28 例(18 %),ST段压低18例(7.2%),T波低平29例(11.6%),T波倒置12例(4.8%),未发生变化143例(57.2%)。结论化疗药物泰索帝和阿霉素对心脏有毒性,能够引起心包积液和心肌不同程度损伤,造成慢性心肌缺血缺氧,从而引起心电图QRS波群及ST-T的异常改变。

Objective To study the effects of taxotere and adriamycin based chemotherapy on the electrocardiogram (ECG) of patients with locally advanced or metastatic breast cancer. Methods Chemotherapy combining taxotere (75 mg/m2) and adriamycin (5 mg/m2) once every 3 weeks was performed in 250 patients with locally advanced or metastatic breast cancer. Electrocardiograph was recorded before and after each treatment course for a total of 10 courses. Results After the completion of the 10 treatment courses, 8 (3.2%) patients had accelerated heart rate, 12 presented low voltage of QRS complex in the limb leads, and Q-T interval extension, ST segment depression, T-wave flattening, T-wave inversion occurred in 28, 18, 29, and 12 patients, respectively. The rest patients had no ECG changes. Conclusions Taxotere and adriamycin as antitumor chemotherapeutic drugs may cause toxicity in the heart, and result in pericardial effusion, myocardial injury, chronic myocardial ischemia or hypoxia that may lead to abnormal changes in QRS complex and ST-T segment in ECG.