乳腺癌放化疗患者超声心动图及心电图特征分析  

Exploration of echocardiographic electrocardiographic characteristics in breast cancer patients with cardiac dysfunction after chemoradiotherapy

作　　者：徐愫婕 叶逢松[1] 武陈斌 吴爱菊[1] 朱双媚 XU Sujie;YE Fengsong;WU Chenbin;WU Aiju;ZHU Shuangmei(Department of Tumor Radiotherapy,Lishui People's Hospital,Lishui 323000,China)

机构地区：[1]丽水市人民医院放疗室,323000

出　　处：《心电与循环》2021年第6期624-628,共5页Journal of Electrocardiology and Circulation

摘　　要：目的分析放化疗对乳腺癌患者心功能、心肌损伤的影响。方法选取2018年4月至2020年6月丽水市人民医院收治的120例乳腺癌患者作为研究对象,其中60例患者采用化疗治疗(对照组)、另外60例患者采用放化疗治疗(观察组),对比两组患者治疗前、治疗中、治疗后的心肌酶学指标[肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、乳酸脱氢酶(LDH)、缺血修饰白蛋白(IMA)]、心功能指标[左心室射血分数(LVEF)、左心室短轴缩短率(LVFS)、左心房室瓣舒张早期E峰/A峰(E/A)、左心室舒张末期内径(LVEDd)、左心室收缩末期内径(LVESd)]、心电图指标[心率、校正后QT时间(QTc)、T波异常率、ST段异常率]的差异。结果观察组患者治疗中、治疗后血清CK、CK-MB、LDH、IMA水平均高于对照组,差异均有统计学意义(均P<0.05)。观察组患者治疗中、治疗后的LVEF低于对照组,观察组治疗中E/A小于对照组,差异均有统计学意义(均P<0.05)。观察组患者治疗中的QTc时间、T波异常发生率大于对照组,差异均有统计学意义(P<0.05)。结论乳腺癌患者同时接受放化疗对患者心功能、心肌损伤的影响较单纯化疗更加明显,应加强超声心动图及心电图的监测。Objective To explore the effect of chemoradiotherapy on cardiac function and myocardial damage in breast cancer patients.Methods A total of 120 breast cancer patients admitted to Lishui People's Hospital from April 2018 to June 2020 were selected as the research objects.Among them,60 patients were treated with chemotherapy(control group),and the other 60 patients were treated with chemoradiotherapy(observation group).Compare the myocardial enzyme indexes(serum CK,CK-MB,LDH,IMA),echocardiographic parameters(LVEF,LVFS,E/A,LVEDd,LVESd),ECG parameters(Heart rate,QTc,abnormal T wave,abnormal ST segment)of the two groups of patients before,during and after treatment.Results Serum levels of CK,CK-MB,LDH and IMA in the observation group were higher than those in the control group during and after treatment,the differences were statistically significant(P<0.05).The LVEF of patients in the observation group during and after treatment was lower than that of the control group,and the measured value of peak E/peak A during treatment of the observation group was lower than that of the control group,the differences were statistically significant(P<0.05).The incidence of abnormal QTc and T waves in the observation group during treatment was greater than that in the control group,the differences were statistically significant(P<0.05).Conclusion Compared with chemotherapy alone,simultaneous chemoradiotherapy for breast cancer patients has a more obvious impact on the heart function and myocardial damage.Therefore,the monitoring of echocardiogram and electrocardiogram indicators can be strengthened for these patients.

关 键 词：乳腺癌 放疗 心功能 心肌损伤 

分 类 号：R737.9[医药卫生—肿瘤]