胸部放疗患者发生急性冠状动脉综合征的影响因素分析  

Analysis on influencing factors of acute coronary syndrome occurrence in patients receiving chest radiotherapy

作　　者：李锦秋[1] 张志林[1] 杜炜[1] 席强[1] 田桂英[1] 卢秀荣[1] 王义成[2] 韩潮[2] LI Jinqiu;ZHANG Zhilin;DU Wei;XI Qiang;TIAN Guiying;LU Xiurong;WANG Yicheng;HAN Chao(Department of Radiotherapy,First Affiliated Hospital of Hebei North University,Zhangjiakou,Hebei 075000,China;Department of Ultrasound Medicine,First Affiliated Hospital of Hebei North University,Zhangjiakou,Hebei 075000,China)

机构地区：[1]河北北方学院附属第一医院放疗科,河北张家口075000 [2]河北北方学院附属第一医院超声医学科,河北张家口075000

出　　处：《重庆医学》2020年第9期1464-1467,共4页Chongqing medicine

基　　金：2015年度河北省医学科学研究重点课题计划项目(20150477)。

摘　　要：目的探讨左侧胸部放疗患者急性冠状动脉综合征(ACS)发病率影响因素及ACS及时救治率较低的原因。方法回顾性分析2015年3月至2017年9月该院放疗科6076例胸部肿瘤治疗患者的临床资料,其中左侧胸部放疗患者2910例作为观察组,非左侧胸部放疗患者3166例作为对照组,比较两组患者ACS的发生率;对观察组ACS患者的年龄、性别、有无高血压病史、有无蒽环类药物化疗史进行单因素分析,并对观察组ACS的诊断过程及临床转归进行分析。结果观察组确诊为ACS 85例,发生率为2.92%;对照组确诊为ACS 30例,发生率为0.95%,两组患者ACS发生率比较差异有统计学意义(P<0.05)。在观察组患者有蒽环类药物化疗史及合并高血压史均明显影响ACS发生率(P<0.05);年龄及性别因素与ACS发生率无明显影响(P>0.05)。观察组确诊的85例ACS患者中,21例患者达到及时诊断和治疗标准(24.71%);85例ACS患者中ST段抬高型心肌梗死58例,非ST段抬高型心肌梗死9例,不稳定型心绞痛18例;其中81例患者有胸痛和胸闷的临床表现,4例仅表现为胸闷;因ACS导致1个月内死亡17例(20.00%)。结论在胸部放疗患者中左侧胸部放疗患者ACS的发生率较高,可能与蒽环类药物化疗史及合并高血压病史相关。Objective To investigate the influencing factors of acute coronary syndrome(ACS)incidence rate in the patients with left-thoracic radiotherapy and the reasons for the low timely treatment rate of ACS.Methods The clinical data of 6076 patients with chest tumor treated in the radiotherapy department of the hospital from March 2015 to September 2017 were retrospectively analyzed.Among them,2910 cases of left thoracic radiotherapy served as the observation group;3166 cases of non-left thoracic radiotherapy as the control group.Then the incidence rates of ACS were compared between the two groups.The univariate analysis on the age,gender,hypertension history and anthracyclines chemotherapy history was performed in the ACS cases of the observation group.Its diagnosis process and clinical outcomes were analyzed.Results Eighty-five cases of ACS were diagnosed in the observation group with the occurrence rate of 2.92%,while 30 cases of ACS in the control group were diagnosed with the occurrence rate of 0.95%,and the ACS occurrence rate had statistical difference between the two groups(P<0.05).In the observation group,the anthracyclines chemotherapy history and complicating hypertension history all affected the ACS occurrence rate,and the difference was statistically significant(P<0.05);the age and gender had no significant effect on the incidence rate of ACS(P>0.05).Among 85 cases of ACS in the observation group,21 cases(24.71%)reached the criteria for timely diagnosis and treatment;there were 58 cases of ST-segment elevation myocardial infarction,9 cases of non-ST-segment elevation myocardial infarction,18 cases of unstable angina pectoris;among them,81 cases had the clinical manifestations of chest pain and chest distress,4 cases only had chest distress in the observation group;ACS resulted in17 cases(20.00%)of death within 1 month.Conclusion Among the patients with chest radiotherapy,the incidence rate of ACS is higher in the patients with left-chest radiotherapy,which may be related to the anthracyclines chemotherapy h

关 键 词：胸部肿瘤 放射治疗 急性冠状动脉综合征 

分 类 号：R541.4[医药卫生—心血管疾病]