摘要
背景与目的心功能检查主要用于冠心病、高血压等疾病的诊断及随访,但在恶性肿瘤治疗中心脏功能的损伤已经日益受到关注,故近年来心功能检查在肿瘤患者中的应用也越来越多。本研究旨在观察乳腺癌综合治疗后超声心动图及心电图的变化,探讨两者对乳腺癌综合治疗后心脏损伤的评估价值。方法回顾性分析复旦大学附属肿瘤医院2010年7月—2012年7月收治的160例乳腺癌患者的心电图和超声心动图检测结果,根据治疗方式分为化疗组(75例)、放疗组(45例)及靶向治疗组(40例),比较3组治疗前后超声心动图和心电图检测结果,分析各治疗方式对患者心脏的影响。结果治疗后,3组心率(HR)和校正后的心室复极时间(QTc)比较,差异均有统计学意义(P<0.05),化疗组及靶向治疗组的HR和QTc与治疗前比较,差异均有统计学意义(P<0.05)。治疗后,3组左心室射血分数(LVEF)、左心室短轴缩短率(FS)、左房室瓣舒张早期最大峰值速度(E峰)比较,差异有统计学意义(P<0.05);左房室瓣舒张早期最大峰值速度与舒张晚期最大峰值速度比值(E/A)、舒张早期左房室瓣环组织速度(Ea峰)、舒张早期左房室瓣环组织速度与晚期左房室瓣环组织速度比值(Ea/Aa)比较,差异无统计学意义(P>0.05)。治疗后化疗组、靶向治疗组超声心动图指标与治疗前比较,差异均有统计学意义(P<0.05);治疗后放疗组LVEF、Ea峰、Ea/Aa与治疗前比较,差异有统计学意义(P<0.05),其余指标间差异无统计学意义(P>0.05)。结论化疗、放疗、靶向治疗后乳腺癌患者的心功能均有变化。从超声心动图及心电图结果分析,放疗对心功能的影响较小,化疗及靶向治疗影响较大,且两者差异不明显,靶向治疗对心脏的收缩功能影响较大。
Background and Objective Heart function tests are used mainly used in the diagnosis and follow-up visits of coronary heart disease,hypertension and other diseases. With the injury of cardiac function in the treatment of malignant tumor receiving increasingly more attention,the application of heart function tests on tumor patients have also been increasing in recent years. The study aimed to observe the changes in ultrasonic cardiogram and electrocardiogram after the comprehensive treatment of breast cancer and investigate the clinical value of the two methods in the evaluation of heart injury after comprehensive treatment. Methods A retrospective analysis was conducted on the results of ultrasonic cardiogram and electrocardiogram of 160 patients with breast cancer who were admitted into Fudan University Shanghai Cancer Center from July 2010 to July 2012.According to treatment mode,the patients were divided into three groups： chemotherapy group（ n = 75）,radiotherapy group（ n = 45） and targeted therapy group（ n = 40）. Comparison was made among the three groups in the results of ultrasonic cardiogram and electrocardiogram before and after treatment,and the influence of each treatment mode on heart was analyzed.Results After treatment,three groups were significantly different in the HR and adjusted QTc after treatment（ P 0. 05）,the HR and adjusted QTc of chemotherapy group and targeted therapy group were significantly different from those before treatment（ P 0. 05）. After treatment,the three groups were significantly different（ P 0. 05） in LVEF,FS and E; the three groups were not significantly different（ P 0. 05） in E / A, Ea and Ea / Aa. After treatment, the indexes of ultrasonic cardiogram of the chemotherapy group and targeted therapy group were significantly different（ P 0. 05） from those before treatment; after treatment,the LVEF,Ea and Ea / Aa of radiotherapy group were significantly different from those before treatment（ P 0. 05）,and there were no differences existed in ot
出处
《中国全科医学》
CAS
CSCD
北大核心
2015年第35期4313-4316,共4页
Chinese General Practice
关键词
超声心动描记术
心电描记术
乳腺肿瘤
心脏损伤
化放疗
Echocardiography
Electrocardiography
Breast neoplasms
Heart injuries
Chemoradiotherapy
