肺癌调强放疗后动态心电图改变及影响因素分析

目的:探讨肺癌调强放疗后动态心电图改变特点及影响因素。方法:收取2013年2月至2015年12月之间于我院就诊并进行调强放疗的肺癌患者161例,在治疗前后行24 h动态心电图监测,对动态心电图异常情况进行统计,并对可能产生影响的临床及物理因素进行单因素及多因素分析。结果:治疗前后窦性心律失常无明显差异(P0.05),治疗后偶发房(室性)心律失常、频发房(室性)心律失常、传导阻滞以及ST-T段改变均较治疗前明显增加,治疗后6个月时较治疗后明显下降,差异具有统计学差异(P0.05)。性别、心脏V20、心脏V30、心脏V40以及心脏V50是动态心电图异常的影响因素(P0.05)。性别及心脏V40为动态心电图异常的独立危险因素(P0.05)。结论:调强放疗后偶发房(室性)心律失常、频发房(室性)心律失常、传导阻滞以及ST-T段改变明显升高,性别及心脏V40为动态心电图异常的独立危险因素。

Influence Factors of DCG Change after IMRT for Patients with Lung Cancer

ABSTRACT Objective: To explore the influence factors of dynamic electrocardiogram (DCG) change after intensity modulated rediation therapy (IMRT) for patients with lung cancer. Methods: 161 lung cancer patients underwent IMRT in our hospital from February 2013 to February 2015 were selected. All patients underwent 24 h DCG and the results and the influence factors were analyzed. Results: The occurrence rate of sinus arrhythmia before and after treatment had no statistically significance (P>0.05). The occurrence rate of occasional atrial (ventricular) arrhythmias, frequent atrial (ventricular) arrhythmias, conduction block and changes of ST-T segment after treatment were all higher than before treatment, and the occurrence rate 6 months after treatment were obviously lower than after treatment with statistically significance (P<0.05). The gender and V20~V50 of heart had influence on the changes of DCG. And the gender and V40 were the independent risk factors of abnormal DCG. Conclusion: The occurrence rate of occasional atrial(ventricular) arrhythmias, frequent atrial(ventricular) arrhythmias, conduction block and changes of ST-T segment is getting higher after IMRT for patients with lung cancer, and the gender and V40 are the independent risk factors of abnormal DCG.