食管癌放疗后心电图ST-T段改变的影响因素分析  

Analysis of factors influencing ST-T segment of electrocardiogram after intensity modulated radiotherapy in esophageal carcinoma patients

作　　者：李良军[1] 刘慧玲[1] 吕新[1] 王炳乾 刘苏城 Li Liangjun;Liu Huiling;Lyu Xin;Wang Bingqian;Liu Sucheng(Electrocardiographic Room,Affiliated Hospital of Jining Medical University,Jining 272029,China)

机构地区：[1]山东省济宁医学院附属医院心电图室,济宁272029

出　　处：《广西医科大学学报》2018年第10期1345-1349,共5页Journal of Guangxi Medical University

摘　　要：目的:探讨食管癌调强放疗后动态性心电图ST-T段改变的影响因素。方法:选择2014年1月至2016年12月在山东省济宁医学院附属医院接受首程调强放疗的186例食管癌患者作为研究对象。分别于治疗前、后检测24h动态心电图,统计ST-T段改变情况,并采用单因素和多因素Logistic回归分析方法分析心电图ST-T段改变的影响因素。结果:放疗后1d,34例患者心电图ST-T段出现改变。放疗后6个月,25例患者心电图ST-T段出现改变,均非新发患者。男性是放疗后1d及放疗后6个月心电图异常的独立保护因素(OR=0.149,P<0.05;OR=0.055,P<0.05),较高的心脏V40是心电图异常的独立危险因素(OR=1.119,P<0.05;OR=1.075,P<0.05)。心脏V40对预测放疗后1d、6个月心电图ST-T段改变的最佳界值分别为25.43%、24.98%。结论:食管癌调强放疗后心电图ST-T段改变发生率较高,性别和心脏V40是其独立影响因素。Objective：To investigate the factors affecting ST-T segment of electrocardiogram（ECG）after intensity modulated radiotherapy（IMRT）in esophageal carcinoma patients.Methods：A total of 186 esophageal cancer patients treated with IMRT in our hospital from January 2014 to December 2016 were selected.24 hdynamic ECG were detected before and after treatment.The factors affecting ECG ST-T segment were analyzed by univariate and multivariate logistic regression analysis.Results：One day after radiotherapy,34 patients were found with ST-T segment changes,and 25 cases with ST-T segment changes at six months post-radiotherapy.Male was an independent protective factor for ECG abnormalities after 1 day and6 months of radiotherapy（OR=0.149,P〈0.05;OR=0.055,P〈0.05）,while high cardiac V40 was the independent risk factor for ECG abnormalities（OR=1.119,P〈0.05）.The best cut-off value of cardiac V40 for predicting ST-T segment changes after 1 day and 6 months of radiotherapy were 25.43%and 24.98%,respectively.Conclusion：The ECG ST-T segment often changed after IMRT treatment in esophageal cancer patients.Gender and cardiac V40 were independent factors affecting ECG ST-T segment.

关 键 词：食管癌 调强放疗 动态心电图 影响因素 

分 类 号：R735.1[医药卫生—肿瘤]