肺癌和乳腺癌调强放疗致动态心电图改变的相关因素分析  

A clinical study of the influential factors of dynamic electrocardiogram changes after intensity modulated radiation therapy for the lung cancer and breast cancer

作　　者：覃晓波[1] 张琴[1] 杨苏萍[1] 陈晓婕[1] 吴洁[1] 

机构地区：[1]广西壮族自治区人民医院心电诊断科,南宁530021

出　　处：《重庆医学》2014年第15期1840-1842,1845,共4页Chongqing medicine

基　　金：广西科学研究与技术开发基金资助项目(桂科攻1355005-3-14);广西卫生厅重点课题基金资助项目(桂卫重2012103);南宁市青秀区科学研究与技术开发基金资助项目(2012S04)

摘　　要：目的探讨肺癌和乳腺癌调强放疗(IMRT)后动态心电图(DCG)改变的相关因素。方法收集接受IMRT左肺癌43例和左乳腺癌39例,分别于治疗前后进行24hDCG监测,分析患者临床资料及剂量-体积直方图(DVH)参数对IMRT后DCG改变的影响。结果 IMRT后出现DCG改变32例(占39%),将患者临床资料及DVH参数进行Logistic分析,发现性别(OR=1.52,P<0.05)、心脏V40>22%(OR=1.15,P<0.05)与DCG改变密切相关。结论肺癌和乳腺癌患者IMRT治疗后以偶发房(室)性心律失常、ST-T改变为主,性别及心脏V40是其发生的独立危险因素。Objective To study of the influential factors of dynamic electrocardiogram （DCG）changes after intensity modulated radiation therapy（IMRT） for the lung cancer and breast cancer .Methods IMRT was delivered to 43 patients with lung cancer and 39 patients with breast cancer ,and they were installed DCG before and after the therapy .The associations of clinical and DVH fac‐tors with DCG changed after IMRT were analyzed .Results 32 patients have abnormal DCG after IMRT （39% ） ,the clinical data and physical factors were analyzed by Logistic regression ,gender（OR=1 .52 ,P〈0 .05） and heart V40〉22% （OR=1 .15 ,P〈0 .05） were the independent influencing factors for abnormal DCG .Conclusion The rate of abnormal DCG is low after IMRT for the lung cancer and breast cancer ,and gender and heart V40 were the independent influencing factors for abnormal DCG .

关 键 词：胸部肿瘤 调强放射治疗 动态心电图 剂量-体积直方图 

分 类 号：R734.2[医药卫生—肿瘤] R737.9[医药卫生—临床医学]