动态心电图联合心肌酶谱指标对肺癌患者放射性心功能损伤的评估价值  

Evaluation value of dynamic electrocardiogram combined with myocardial enzyme spectrum indicators for radiation-induced heart disease in lung cancer patients

作　　者：靳雨 文雯 郜辉 JIN Yu;WEN Wen;GAO Hui(Department of Cardio-Pulmonary Function,Zhengzhou Central Hospital Affiliated to Zhengzhou University,Zhengzhou 450000,He’nan,China;Daytime Chemotherapy Center,Zhengzhou Central Hospital Affiliated to Zhengzhou University,Zhengzhou 450000,He’nan,China)

机构地区：[1]郑州大学附属郑州中心医院心肺功能科,郑州450000 [2]郑州大学附属郑州中心医院日间化疗中心,郑州450000

出　　处：《癌症进展》2025年第2期232-235,共4页Oncology Progress

摘　　要：目的探讨动态心电图(DCG)联合心肌酶谱指标对肺癌患者放射性心功能损伤(RIHD)的评估价值。方法选取175例肺癌患者,其中95例患者发生RIHD,80例患者未发生并发症,分别作为观察组和对照组。比较放疗前、不同放疗时间两组患者心肌酶谱指标[肌酸激酶(CK)、天冬氨酸氨基转移酶(AST)、肌酸激酶同工酶(CK-MB)],以及不同放疗时间观察组患者的DCG异常改变情况。评估DCG、心肌酶谱指标单独及联合检测对肺癌患者RIHD的检出情况。结果放疗前,观察组患者CK、AST、CK-MB水平均明显高于对照组,差异均有统计学意义(P﹤0.01)。随着放疗时间的延长,CK、AST、CK-MB水平逐渐升高,心律异常、ST-T改变、束支传导阻滞、房室传导阻滞发生率逐渐升高,差异均有统计学意义(P﹤0.05)。DCG、心肌酶谱指标联合检测对肺癌患者RIHD的检出率为94.74%,高于DCG的85.26%及心肌酶谱指标的74.74%,差异均有统计学意义(P﹤0.05)。结论随着放疗时间的延长,肺癌合并RIHD患者的DCG异常改变情况逐渐加重,心肌酶谱指标逐渐升高,DCG联合心肌酶谱指标对肺癌患者RIHD的检出率高于二者单独检测。Objective To investigate the evaluation value of dynamic electrocardiogram(DCG)combined with myocardial enzyme spectrum indicators for radiation-induced heart disease(RIHD)in lung cancer patients.Method A total of 175 lung cancer patients were selected,included 95 patients who developed RIHD and 80 patients who did not developed complications,as the observation group and control group,respectively.The myocardial enzyme spectrum indicators[creatine kinase(CK),aspartate aminotransferase(AST),creatine kinase isoenzyme(CK-MB)]of two groups before radiotherapy and at different radiotherapy times,as well as the abnormal changes of DCG in observation group at different radiotherapy times were compared.The DCG and myocardial enzyme spectrum indicators single and combined detection in diagnosis of RIHD in lung cancer patients were evaluated.Result Before radiotherapy,the levels of CK,AST and CK-MB in observation group were significantly higher than those in control group,and the differences were statistically significant(P<0.01).With the prolongation of radiotherapy time,the levels of CK,AST and CK-MB gradually increased,and the incidences of heart rate abnormalities,ST-T changes,bundle branch block,and atrioventricular block gradually increased,and the differences were statistically significant(P<0.05).The detection rate of RIHD in lung cancer patients by DCG,myocardial enzyme spectrum indicators combined detection was 94.74%,which was higher than 85.26%of DCG and 74.74%of myocardial enzyme spectrum indicators,and the differences were statistically significant(P<0.05).Conclusion With the prolongation of radiotherapy time,the abnormal changes of DCG in lung cancer patients with RIHD gradually worsen,and the myocardial enzyme spectrum indicators gradually increase.The detection rate of RIHD in lung cancer patients by DCG combined with myocardial enzyme spectrum indicators is higher than each indicator single detection.

关 键 词：肺癌 放射性心功能损伤 动态心电图 心肌酶谱 

分 类 号：R734.2[医药卫生—肿瘤]