摘要
目的探讨40例鼻咽癌患者放射治疗后QT离散度和心电图的改变。方法对40例鼻咽癌患者逐步实施3个阶段的放射治疗,放射剂量分别为15～25 Gy、35～45 Gy和55～65 Gy,同时在每一个治疗阶段均作24 h动态心电图监测,观察放射治疗后致QT离散度(QTd)、校正后QT离散度(QTcd)与心电图改变的情况。结果鼻咽癌患者放射治疗前和3个阶段放射治疗后,①动态心电图中QTd、QTcd指标比较,差异均无统计学意义(P>0.05);②室上性心律失常、室性心律失常和ST-T改变的发生率比较,差异亦均无统计学意义(P>0.05)。结论 QTd、QTcd指标在放射剂量为15～25 Gy时呈下降趋势、35～45 Gy时呈上升趋势、55～65 Gy时恢复到治疗前水平。室性心律失常和ST-T改变的发生率走势相似,放射剂量为15～25 Gy时呈上升趋势、35～45 Gy时呈下降趋势、55～65 Gy时呈明显上升趋势,提示有待进一步观察与研究。
Objective ToinvestigatethechangesofQTdispersionandECGin40casesofpa-tientswithnasopharyngealcarcinomaafterradiotherapy.Methods Thefortypatientswereenrolled in the radiotherapy of 3 phases with gradually increased radiological dose of 1 5 -25 Gy,35 -45 Gy and 55 -65 Gy.Meanwhile,24-hour ambulatory electrocardiography（AECG）monitoring was car-ried out in each phase of radiotherapy.The changes of QT dispersion（QTd）,corrected QT disper-sion（QTcd）andECGchangesinducedbytheradiotherapywereobserved.Results Thispaper made a comparison among the patients before radiotherapy and after 3 phases of radiotherapy,and the results were as follows.①In AECG,the differences of indexes of QTd and QTcd weren’t statis-tically significant（P＆gt;0.05）;② There was also no statistical significance（P＆gt;0.05）in the differ-ences of the incidence rates of supraventricular arrhythmia,ventricular arrhythmia and ST-T chan-ges.Conclusion TheindexesofQTdandQTcddecreasedataradiologicaldoseof15-25Gy,in-creased at a dose of 35 -45 Gy and returned to pre-treatment levels at a dose of 55 -65 Gy.The trends of the incidence rates of ventricular arrhythmia and ST-T changes were similar,which per-formed as an increased trend at a radiological dose of 1 5 -25 Gy,a decreased trend at a dose of 35 -45 Gy and a significant increased trend again at a dose of 55 -65 Gy.It deserves further obser-vation and investigation.
出处
《江苏实用心电学杂志》
2014年第2期87-90,共4页
Journal of Practical Electrocardiology JS
基金
广西卫生厅自筹经费科研课题(Z2011428)
广西卫生厅重点课题(桂卫重2011117)
关键词
鼻咽癌
心律失常
QT离散度
动态心电图
nasopharyngealcarcinoma
arrhythmia
QTdispersion
ambulatoryelectrocardiography
