胸部肿瘤调强放疗后动态心电图异常探究

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1、胸部肿瘤调强放疗后动态心电图异常探究　　广西壮族自治区人民医院心电诊断科，广西南宁530021[摘要]目的探讨调强放疗（IMRT）对胸部肿瘤患者不同时间段、不同类型肿瘤、不同治疗方法动态心电图（DCG）的改变。方法接受IMRT的胸部肿瘤患者126例，按照肿瘤类型分为左肺癌组43例，左乳癌组39例，食管癌组44例，按照治疗方法分为单纯放疗组36例，同步放化组46例，序贯放化组44例，分别于治疗前、后，治疗结束半年后进行24hDCG监测，比较治疗前、治疗结束时、半年后DCG异常发生率及各组治疗前后DC

2、G异常例数。结果偶发房（室）性心律失常、ST-T改变在治疗后较治疗前明显增加，差异有统计学意义（χ2=6.21，P=0.013；χ2=15.14，P=0.000），两者在治疗前与治疗结束半年后比较，差异无统计学意义（P>0.05）；治疗前、后不同类型三组肿瘤、不同治疗方法三组患者比较，DCG异常发生例数差异均无统计学意义（P>0.05）。结论胸部肿瘤患者IMRT后DCG改变多出现在治疗早期，为可逆性的；不同类型胸部肿瘤，由于IMRT的精确性，其放疗后DCG改变相似；紫杉类+铂类化疗方案对DCG影响

3、较小，其心脏毒性相对较低。[关键词]胸部肿瘤；调强放射治疗；动态心电图11[中图分类号]R734[文献标识码]A[文章编号]1673-7210（2014）03（a）-0078-04StudyonchangesofdynamicelectrocardiograminpatientswiththoracicneoplasmafterintensitymodulatedradiationtherapyCHENXiaojieQINXiaoboZHANGQinYANGSupingWUJieDepartmen

4、tofElectrocardiogram，thePeople’sHospitalofGuangxiZhuangAutonomousRegion，GuangxiZhuangAutonomousRegion，Nanning530021，China[Abstract]ObjectiveToexplorethechangesofdynamicelectrocardiogram（DCG）atdifferentstages，fordifferentkindsofneoplasmsandwithdifferen

5、ttherapeuticmethodsforpatientswiththoracicneoplasmtreatedwithintensitymodulatedradiationtherapy（IMRT）.Methods126patientswiththoracicneoplasmtreatedwithIMRTweredividedinto3groupsaccordingtokindsofneoplasm.Amongthem，therewere43patientsinleftlungcancergr

6、oup，39patientsinleftmastocarcinomagroupand44patientsinesophagealcancergroup.Andaccordingtotherapeuticmethods，thepatientswere11dividedinto3groups，includingradiotherapygroup（n=36），synchronalchemoradiationgroup（n=46），andsequentialchemoradiationgroup（n=44

7、）.Allgroupsweretestedwith24-hourDCGbeforeandaftertreatmentandhalfayearlatertocomparetheabnormityincidenceratesatdifferentstagesincludingthenewlyincreasedrates.ResultsOccasionalatrialandventricularprematurebeats，ST-Tchangesincreasedmoresignificantlyaft

8、ertreatmentthanbeforewithstatisticalsignificance（χ2=6.21，P=0.013；χ2=15.14，P=0.000）.Butforthemtherewasnostatisticaldifferencebeforetreatmentandhalfayearaftertheend（P>0.05）.Therewasnostatisticaldifferenceamong3groupswithdifferenttypesortreatment