恶性肿瘤患者在化疗期间心电图的改变

目的分析恶性肿瘤患者在化疗期间体表心电图的改变。方法记录200例恶性肿瘤患者化疗前,化疗后3天、1周、1个月同步标准15导联心电图检查,其中男104例,女96例。观察心脏节律及R波振幅、ST-T变化。结果接受化疗后3天心电图异常发生率(80.0%)明显高于接受化疗后1周(65.5%)和接受化疗后1个月(49.0%)(P0.05)。接受化疗3天后,≥60岁组(n=90)窦性心动过缓、T波低平、ST段下移发生率明显高于20岁组(n=25)和20~59岁组(n=85)(P0.05)。含蒽环类化疗方案心电图R波低电压、T波低平和ST段下移的发生率明显高于不含蒽环类的化疗方案(89.0%vs 74.7%,P0.05)。结论化疗所致的心电图异常发生率随着化疗后时间的延长而下降;随着年龄的增加而增加。各种化疗方案均可能存在心脏毒性作用,含蒽环类的化疗方案尤为明显。

The changes of electrocardiography in the patients with cancer during the chemotherapy

Objective To analyze the changes of electrocardiography in the patients with malignant tumor during the chemotherapy. Methods Two hundred patients with malignant tumor accepting chemotherapy was enrolled, included 104 male and 96 female, to investigate the heart rhythm, the voltage of R wave, and the change of ST-T by 15-lead ECGs before chemotherapy, after three-day chemotherapy, after one-week chemotherapy, after one-month chemotherapy. Re- suits The incidence of abnormal ECGs after one-week chemotherapy and after one-month chemotherapy was lower than that after three-day chemotherapy （ P 〈 0.05 ）. After three-day chemotherapy, the incidence of abnormal ECGs in the group aged over 60 years （ n = 90） was higher than that in the group aged less than 20 years （ n = 25 ） and the group aged between 20 and 59 years （ n = 85 ） （ P 〈 0.05）. The incidence of low voltage R wave, low T wave, ST segment depression in the group treated with anthracyclines was higher than that in the group treated without anthracyclines （89.0% vs 74.7% ,P 〈 0.05）. Conclusion The incidence of abnormal ECGs is related to the time, drugs and age in patients with cancer during chemotherapy. Most of the chemotherapy programs induce cardiotoxicity, especially in the chemotherapy included anthracyclines.