肺癌调强放疗后动态心电图改变及影响因素分析  

Influence Factors of DCG Change after IMRT for Patients with Lung Cancer

作　　者：王波[1] 宋伟男[1] 曹文颖[2] 王兰[2] 张佩娟[1] 

机构地区：[1]青岛市肿瘤医院心功能检查科,山东青岛266042 [2]北京大学人民医院心内科,北京100044

出　　处：《现代生物医学进展》2017年第16期3144-3147,共4页Progress in Modern Biomedicine

摘　　要：目的:探讨肺癌调强放疗后动态心电图改变特点及影响因素。方法:收取2013年2月至2015年12月之间于我院就诊并进行调强放疗的肺癌患者161例,在治疗前后行24 h动态心电图监测,对动态心电图异常情况进行统计,并对可能产生影响的临床及物理因素进行单因素及多因素分析。结果:治疗前后窦性心律失常无明显差异(P>0.05),治疗后偶发房(室性)心律失常、频发房(室性)心律失常、传导阻滞以及ST-T段改变均较治疗前明显增加,治疗后6个月时较治疗后明显下降,差异具有统计学差异(P<0.05)。性别、心脏V20、心脏V30、心脏V40以及心脏V50是动态心电图异常的影响因素(P<0.05)。性别及心脏V40为动态心电图异常的独立危险因素(P<0.05)。结论:调强放疗后偶发房(室性)心律失常、频发房(室性)心律失常、传导阻滞以及ST-T段改变明显升高,性别及心脏V40为动态心电图异常的独立危险因素。Objective： To explore the influence factors of dynamic electrocardiogram （DCG） change after intensity modulated rediation therapy （IMRT） for patients with lung cancer. Methods： 161 lung cancer patients underwent IMRT in our hospital from February 2013 to February 2015 were selected. All patients underwent 24 h DCG and the results and the influence factors were analyzed. Results： The occurrence rate of sinus arrhythmia before and after treatment had no statistically significance （P〉0.05）. The occurrence rate of occasional atrial （ventricular） arrhythmias, fi＇equent atrial （ventricular） arrhythmias, conduction block and changes of ST-T segment after treatment were all higher than before treatment, and the occurrence rate 6 months after treatment were obviously lower than after treatment with statistically significance （P〈0.05）. The gender and V20NV50 of heart had influence on the changes of DCG. And the gender and V40 were the independent risk factors of abnormal DCG. Conclusions： The occurrence rate of occasional atrial（ventricular） arrhythmias, frequent atrial （ventricular） arrhythmias, conduction block and changes of ST-T segment is getting higher after IMRT for patients with lung cancer, and the gender and V40 are the independent risk factors of abnormal DCG.

关 键 词：肺癌 调强放疗 动态心电图 影响因素 

分 类 号：R734.2[医药卫生—肿瘤]