食管癌放射治疗后远期致放射性心脏损伤4例报告

目的:分析食管癌放射治疗后远期致放射性心脏损伤的特点。方法:2008年3月至2010年5月收住入院的食管癌放射治疗后伴晕厥患者四例,男1例,女3例。行心电图明确基本心律;冠脉造影评价冠脉病变;心脏彩超评估心功能。结果:①4例患者均为三度房室传导阻滞,行永久性心脏起搏器植入术;②冠脉造影均提示多支狭窄,并行介入治疗;③EF值明显下降,抗心衰治疗;④出院随访,生存期15²7月。结论:食管癌放射治疗后远期可致心脏传导系统损害、冠状动脉病变和心肌损伤,预后差。

Radiation-induced heart disease after radiotherapy for esophageal carcinoma in the long term： report of four cases

Objective：To analysis characteristics of radiation-induced heart disease after radiotherapy for esophageal carcinoma in the long term. Methods： The data of four cases with syncope following the radiotherapy for esophageal carcinoma from March 2008 to May 2010 in our hospital were collected. These patients consisted of three males and one female. All patients received the electrocardi- ogram, coronary angiography and echocardiography. Results ： （ 1 ） All patients had three degree atrioventricular block and underwent a permanent pacemaker implantation. （2） Coronary angiography showed multi-vessel stenosis and all patients received an interventional treatment. （3） Ejection fraction （EF） of the four patients decreased significantly, and the clinical symptoms of heart failure were im- proved after the treatment. （4） Follow-up： the survival period was 15-27 months. Conclusions： The radiotherapy for esophageal car- cinoma in the long term could cause cardiac conduction system damage, coronary artery disease and myocardial damage, and has a poor prognosis.