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目的探讨不同放疗剂量对鼻咽癌患者QT离散度、心率变异性时域、频域指标及心电图的影响。方法接受放疗的73例鼻咽癌患者逐步进行15~25、35~45、55~65 Gy剂量的放射治疗,观察放疗前后QT离散度(QTd)、校正后QT离散度(QTcd)、NN间期标准差(SDNN)、NN间期均值标准差(SDANN)、相邻NN间期均值的均方根(r MSSD、NN相邻间期差值超过50 ms的心搏数所占百分比(p NN50);频域指标:极低频功率(VLF)、低频功率(LF)、高频功率(HF)、LF/HF、总功率(TP)等。结果与治疗前比较,患者接受15~25、35~45、55~65 Gy治疗后,SDNN、r MSSD、p NN50、TP、VLF、LF、HF均降低,且随着放疗剂量的增加不断降低(P<0.05);窦性心律失常发生率明显低于放疗前(P<0.05)。结论通过监测放疗过程中QTd、QTcd、HRV时域指标、频域指标,可以密切监测鼻咽癌患者心脏自主神经功能的变化,为评估放疗及预后提供一定依据。
Objective To investigate the effects of different doses of radiation on QT dispersion, heart rate variability in time domain, frequency domain and electrocardiogram in patients with nasopharyngeal carcinoma. Methods 73 cases of nasopharyngeal carcinoma patients undergoing radiotherapy were treated with 15 ~ 25,35 ~ 45,55 ~ 65 Gy doses of radiotherapy. QTd, QTcd, SDNN, SDANN, mean square root of adjacent NN mean (r MSSD, the percentage of heart rate whose NN interval interval exceeded 50 ms (p NN50), frequency domain index (VLF), low frequency power (LF), high frequency power (HF), LF / HF, total power and so on.Results Compared with before treatment, patients received 15-25, After treatment with 35-45 and 55-65 Gy, SDNN, r MSSD, p NN50, TP, VLF, LF and HF decreased, and decreased with the increase of radiotherapy dose (P <0.05). The incidence of sinus arrhythmia (P <0.05) .Conclusion The changes of cardiac autonomic nervous function in patients with nasopharyngeal carcinoma can be closely monitored by monitoring the time-domain QTd, QTcd, HRV time-domain and frequency-domain indexes during radiotherapy, so as to evaluate the radiotherapy and prognosis Some basis.