动态心电图监测含氟尿嘧啶方案治疗头颈部恶性肿瘤所致心脏毒性的效果观察  

The effect of cardiotoxicity of fluorouracil monitored with dynamic electrocardiogram on patients with head and neck cancer

作　　者：胡镐传 刘文健 石硙硙 沈永奇[2] 梁秀群 张青 黄汉生 斯韬 孔祥应 林海永 Hu Haochuan;Liu Wenjian;Shi Weiwei;Shen Yongqi;Liang Xiuqun;Zhang Qing;Huang Hansheng;Si Tao;Kong Xiangying;Lin Haiyong(Department of Oncology,Rongshui County People's Hospital,Liuzhou,Guangxi 545300,China;Department of Oncology,Liutie Center Hospital,Liuzhou,Guangxi 545007,China;Department of Electrocardiography Liutie Center Hospital,Liuzhou,Guangxi 545007,China;The Department of Pharmacy of Liujiang District people's Hospital,Liuzhou,Guangxi 545100,China;The Chemotherapy Department of Liuzhou Oncology Hospital,Liuzhou,Guangxi 545001,China;Department of Oncology,Traditional Chinese Medicine Hospital,Liuzhou,Guangxi 545001,China;Department of Oncology,Qiannan Traditional Chinese Medicine Hospital,Duyun,Guizhou 558003,China;Department of Oncology,The Second People's Hospital of Pingnan county,Guigang,Guangxi 537300,China)

机构地区：[1]柳州市融水县人民医院肿瘤科,广西柳州545300 [2]柳州市柳铁中心医院肿瘤科,广西柳州545007 [3]柳州市柳铁中心医院心电功能科,广西柳州545007 [4]柳州市柳江区人民医院药剂科,广西柳州545100 [5]柳州肿瘤医院化疗科,广西柳州545001 [6]柳州市中医医院肿瘤科,广西柳州545001 [7]黔南州中医医院肿瘤科,贵州都匀558003 [8]平南县第二人民医院肿瘤科,广西贵港537300

出　　处：《医药前沿》2020年第36期43-45,共3页Journal of Frontiers of Medicine

基　　金：广西卫生健康委员会科研项目(Z20190448)。

摘　　要：目的:观察24h动态心电图(24h-D C G)在监测含氟尿嘧啶(5-F U)类药物方案治疗头颈部恶性肿瘤(H N C)相关心脏毒性中的作用。方法:将柳州市融水县人民医院肿瘤科等7个肿瘤中心2015年7月—2018年6月接诊的、同意使用含氟尿嘧啶方案化疗的H N C患者共89例,根据患者及家属的治疗意愿分为观察组(48例)及对照组(41例)。在每疗程化疗前后,观察组用24h-DCG、对照组用12导联心电图(ECG)监测心电活动,通过对比分析,比较两种方法在检测含5-FU类药物方案的心脏毒性的发生率、严重程度等方面的差异。结果:两组可评价患者共78例,其中观察组42例,对照组36例。观察组总的心电图异常改变及Ⅰ级心脏毒性的发生率显著高于对照组(P<0.05);而两组Ⅱ~Ⅳ级心脏毒性的发生率则无显著差异(P>0.05),但观察组有更轻的趋势。结论:24h-DCG比12导联ECG检测氟尿嘧啶类药物治疗HNC所致的心脏毒性更加灵敏,能更易、更早发现心脏毒性。Objective To evaluate the cardiotoxicity of fluorouracil(5-FU)with 24-hours dynamic electrocardiogram(24h-DCG)on Head and neck cancer(HNC)patients.Methods A total of 89 HNC patients admitted to Department of Oncology,Rongshui County People's Hospitalof Liuzhou city and other 7 Cancer Centers from July 2015 to June 2018,who accept 5-FU were divided into observation group(48 cases)and control group(41cases)with a prospective non-random method according to the wishes of patients.The former used 24h-DCG and the latter used 12-lead electrocardiograph(ECG)to monitor ECG abnormalities.The effects of 24h-DCG and 12-lead ECG on monitoring the incidence,severity and chemotherapy cycles numbers of cardiotoxicity were compared.Results Seventy-eight patients meet the requirements,42 cases of the observation group and 36 cases of the control group.The totol incidence of ECG abnormalities and the incidence ofⅠdegree cardiac toxicity of the observation group is apparently higher than the control group,the difference was statistically significant(P<0.05).The incidence ofⅡ,ⅢandⅣdegree cardiac toxicity of the two groups were no statistically significant difference(P>0.05),but the observation group tended to be lighter.Conclusion The 24h-DCG is more sensitive than the 12-lead ECG on monitoring the cardiotoxicity of 5-FU used in the HNC patients,so the cardiotoxicity can be detected more easily and earlier.

关 键 词：氟尿嘧啶 头颈部恶性肿瘤 心脏毒性 动态心电图 

分 类 号：R730.5[医药卫生—肿瘤]