紫杉醇药物化疗对恶性肿瘤患者的心电损伤  

The cardiac electrical activity injury caused by paclitaxel chemotherapy for patients with malignant tumors

作　　者：王蕊[1] 杜晓峰[1] 罗宙红[1] Wang rui;Du xiaofeng;Luo zhouhong(Department of Cardiophysiology Function,Tumor Hospital,Xinjiang Medical University,Ummqi,830011,China)

机构地区：[1]新疆医科大学附属肿瘤医院,830011

出　　处：《临床心电学杂志》2021年第3期192-194,共3页Journal of Clinical Electrocardiology

摘　　要：目的本研究通过比较恶性肿瘤患者在紫杉醇药物化疗前后心电图的变化,评估当前临床常用的含紫杉醇药物化疗药物对心脏电生理活动的毒性作用,为临床用药提供安全性的依据。方法比较180例恶性肿瘤患者在化疗前,化疗后3天、l周、1个月时的常规12导联心电图和24小时动态心电图的变化。观察心脏节律及QRS波电压、ST-T,QT间期,心率变异性(HRV)变化。结果患者化疗后3天心电图异常的发生率(75.5%)高于化疗后l周(58.5%)和化疗后1个月(41.3%)(p<0.05)。患者化疗3天后,年龄>60岁组(n=64)患者窦性心动过缓、T波改变、ST段压低发生率高于年龄<35岁组(n=11)和35-60岁组(n=105)(p<0.05)。患者化疗后的SDNN、SDANN、RMSSD、pNN50比化疗前降低,差异均具有显著的统计学意义(p<0.01)。结论紫杉醇药物化疗所致心电图变化的发生率随着化疗后时间的延长而降低;随着患者年龄的增长而增加。Objective This experiment compared the changes of electrocardiogram(ECG)in patients with malignant tumors caused by paclitaxel chemotherapy,to assess the toxic effects of cardiac electrophysiological activities caused by the clinical commonly used chemotherapy for patients,provide the basis for the safety of clinical use.Methods One hundred and eighty patients with malignant tumor accepting chemotherapy was enrolled.We investigated the heart rhythm,the voltage of QRS wave,the change of ST-T,QT interval and heart rate variability(HRV)by using 12-lead ECG and 24 hours dynamic electrocardiogram before chemotherapy,after three-day chemotherapy,after one-week chemotherapy,after one-month chemotherapy.Results The incidence of abnormal ECGs after one-week chemotherapy and after one-month chemotherapy was lower than that after three-day chemotherapy(p<0.05).After three-day chemotherapy,the incidence of abnormal ECGs in the group aged over 60 years(n=64)was higher than that in the group aged less than 35 years(n=11)and the group aged between 35 and 60 years(n=105)(p<0.05).Comparison between the two groups in HRV:SDNN,SDANN,RMSSD,pNN50 of the patients with malignant tumor were all reduced after the chemotherapy(p<0.01).Conclusions The cardiac electrical activity injury caused by paclitaxel chemotherapy for patients with malignant tumors is related to the time and age.

关 键 词：恶性肿瘤 紫杉醇 化疗 心电图 心电损伤 

分 类 号：R541.7[医药卫生—心血管疾病] R540.41[医药卫生—内科学]