紫杉醇联合顺铂治疗后癌症患者心电图改变

目的:探讨化疗药紫杉醇(taxoere)联合顺铂治疗肺癌、乳腺癌、鼻咽癌对心脏的毒性作用导致的心电图改变。方法:对确诊为肺癌的患者170例、乳腺癌152例、鼻咽癌170例共492例患者,经静脉滴注紫杉醇175 mg/m2和顺铂80 mg/m2,以d1、8、15,每周给药方式,每3周停1周作为1个疗程。每个疗程开始前和结束后各观测心电图1次,共动态观察5个疗程。结果:5个疗程结束后,ST-T异常改变129例(26.22%),房性早搏23例(4.67%),QRS波低电压22例(4.47%),心率加快20例(4.06%),窦性心动过缓21例(4.26%),室性早搏20例(4.06%),右束支传导阻滞12例(2.44%),房室传导阻滞8例(1.62%),无明显变化237例(48.2%)。结论:化疗药物紫杉醇和顺铂对心脏的毒性虽然较蒽环类低,但是临床上应用广泛,能够引起心肌不同程度的损伤,造成慢性心肌缺血缺氧,从而引起心电图的ST-T及QRS波群的异常改变。

Electrocardiographic changes in cancer patients after paclitaxel plus cisplatin treatment

Objective To study the changes of electrocardiogram（ECG） in patients with lung cancer,breast cancer and nasopharyngeal cancer after paclitaxel plus cisplatin treatment.Method Chemotheray including paclitaxel（175 mg/m2） and cisplatin（80 mg/m2） for weekly medication（every 3 weeks for 1 week stopping） was performed on 492 patients.Electrocardiograph was recorded before and after each treatment course for a total of 5 courses.Results After the completion of 5 treatment courses,129 patients（26.22%） had ST-T segment abnormal,23 patients（4.67%） had atrial premature beats and low voltage of QRS wave in 22 cases（4.47%）,sinus bradycardia in 21 cases（4.26%）,accelerated heart rate in 20 cases（4.06%）,ventricular premature beat in 20 cases（4.06%）,right bundle branch block in 12 cases（2.44%）,atrioventricular heart-block in 8 cases（1.62%）.The rest patients had no ECG changes.Conclusion Paclitaxel plus cisplatin as antitumor chemotherapeutic drugs may cause toxicity in the heart,and lead to abnormal changes in ST-T segment and QRS complex in ECG.