胸部放射治疗对冠心病患者心脏损害及相关生活质量影响

目的观察胸部放射治疗(放疗)对冠心病患者的心脏损害及相关生活质量影响。方法选择在我院接受胸部放疗的肺癌并冠心病27例作为胸部放疗组,另选择同期在我院就诊未接受胸部放疗的冠心病22例作为对照组,均于治疗前和治疗5周后进行常规超声心动图、组织多普勒左心功能指标检测及心脏相关生活质量评估并比较。结果两组治疗前常规超声心动图、组织多普勒左心功能各项指标及健康调查简易量表(SF-36)各维度评分比较差异均无统计学意(P0.05)。治疗5周后胸部放疗组常规超声心动图左心功能指标左室射血分数(LVEF)、二尖瓣舒张早期峰值流速(E)及E与心房收缩期峰值流速的比值(E/A),组织多普勒左心功能指标平均二尖瓣瓣环舒张早期峰值运动速度(MEm)及MEm与平均二尖瓣瓣环晚期峰值运动速度的比值(MEm/MAm),SF-36 8个维度评分均明显低于治疗前及对照组同一时间检测或评分结果,差异均具有统计学意义(P0.05或P0.01)。结论冠心病患者接受胸部放疗后可对心功能造成损伤,并可能影响其相关生活质量,医护人员应提高警惕,并给予有针对性的康复治疗。

Effect of Thoracic Radiotherapy on Heart Injury and Quality of Life of Patients with Coronary Heart Disease

Objective To observe the effect of thoracic radiotherapy on heart injury and quality of life of patients with coronary heart disease. Methods A total of 27 patients with lung cancer complicated with coronary disease undergoing tho- racic radiotherapy were selected as a thoracic radiotherapy group （ group A） , and another 22 patients with coronary disease at the same period without thoracic radiotherapy were selected as a control group （group B）. All the patients in the two groups underwent examinations of ultrasonic cardiogram and tissue Doppler imaging of left heart function and life quality assessment a- bout the heart before treatment and thoracic radiotherapy for 5 weeks, and the results were also compared. Results There were no significant differences of indexes in routine ultrasonic cardiogram and tissue Doppler imaging of left heart function, and dimensional scores of medical outcomes study （SF-36） in the two groups before thoracic radiotherapy （ P 〉 0.05）. After tho- racic radiotherapy for 5 weeks, values of left ventricular ejection fraction （LVEF） , peak flow rate of mitral valve in early dias- tole （E） , the ratio of E to peak flow rate of atrial systole period （E/A） , mean peak of movement speed of mitral valve in ear- ly diastole （MEm） , the radio of MEre to mean peak of movement speed of mitral valve in advanced stage （MEm/Am） and eight dimensional scores of SF-36 in group A were significantly lower than those before thoracic radiotherapy and in the control group at the same period （ P 〈 0.05 or P 〈 0.01 ）. Conclusion The thoracic radiotherapy may be harmful to heart function and affect quality of life in patients with coronary heart disease, so the patients need a targeted rehabilitative treatment.