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目的:探讨肺癌调强放疗后动态心电图改变特点及影响因素。方法:收取2013年2月至2015年12月之间于我院就诊并进行调强放疗的肺癌患者161例,在治疗前后行24 h动态心电图监测,对动态心电图异常情况进行统计,并对可能产生影响的临床及物理因素进行单因素及多因素分析。结果:治疗前后窦性心律失常无明显差异(P>0.05),治疗后偶发房(室性)心律失常、频发房(室性)心律失常、传导阻滞以及ST-T段改变均较治疗前明显增加,治疗后6个月时较治疗后明显下降,差异具有统计学差异(P<0.05)。性别、心脏V20、心脏V30、心脏V40以及心脏V50是动态心电图异常的影响因素(P<0.05)。性别及心脏V40为动态心电图异常的独立危险因素(P<0.05)。结论:调强放疗后偶发房(室性)心律失常、频发房(室性)心律失常、传导阻滞以及ST-T段改变明显升高,性别及心脏V40为动态心电图异常的独立危险因素。
Objective: To investigate the characteristics and influencing factors of dynamic electrocardiogram (ECG) changes after IMRI in lung cancer. Methods: One hundred and sixty-one patients with lung cancer who underwent IMRT between February 2013 and December 2015 were enrolled in this study. The electrocardiogram was monitored 24 hours before and after treatment, and the abnormality of the electrocardiogram was analyzed. The impact of clinical and physical factors were single factor and multivariate analysis. Results: There was no significant difference in sinus arrhythmia between before and after treatment (P> 0.05). After treatment, occasional atrial (ventricular arrhythmia), frequent atrial (ventricular) arrhythmia, conduction block and ST- Before the treatment significantly increased after 6 months of treatment than after treatment decreased significantly, the difference was statistically significant (P <0.05). Gender, heart V20, heart V30, heart V40 and heart V50 were the influencing factors of the abnormality of ambulatory electrocardiogram (P <0.05). Gender and heart V40 were independent risk factors for abnormal ECG (P <0.05). Conclusion: The changes of sporadic arrhythmias, ventricular arrhythmia, conduction block and ST-T in IOL (IMRT) after IMRT were significantly increased. Gender and cardiac V40 were independent risk factors of abnormal ECG .