超声心动图与心电图对乳腺癌患者综合治疗后心脏损伤的评估

发布时间：2018-02-16 14:36

本文关键词： 超声心动描记术心电描记术乳腺肿瘤心脏损伤化放疗　出处：《中国全科医学》2015年35期 　论文类型：期刊论文

【摘要】：背景与目的心功能检查主要用于冠心病、高血压等疾病的诊断及随访,但在恶性肿瘤治疗中心脏功能的损伤已经日益受到关注,故近年来心功能检查在肿瘤患者中的应用也越来越多。本研究旨在观察乳腺癌综合治疗后超声心动图及心电图的变化,探讨两者对乳腺癌综合治疗后心脏损伤的评估价值。方法回顾性分析复旦大学附属肿瘤医院2010年7月—2012年7月收治的160例乳腺癌患者的心电图和超声心动图检测结果,根据治疗方式分为化疗组(75例)、放疗组(45例)及靶向治疗组(40例),比较3组治疗前后超声心动图和心电图检测结果,分析各治疗方式对患者心脏的影响。结果治疗后,3组心率(HR)和校正后的心室复极时间(QTc)比较,差异均有统计学意义(P0.05),化疗组及靶向治疗组的HR和QTc与治疗前比较,差异均有统计学意义(P0.05)。治疗后,3组左心室射血分数(LVEF)、左心室短轴缩短率(FS)、左房室瓣舒张早期最大峰值速度(E峰)比较,差异有统计学意义(P0.05);左房室瓣舒张早期最大峰值速度与舒张晚期最大峰值速度比值(E/A)、舒张早期左房室瓣环组织速度(Ea峰)、舒张早期左房室瓣环组织速度与晚期左房室瓣环组织速度比值(Ea/Aa)比较,差异无统计学意义(P0.05)。治疗后化疗组、靶向治疗组超声心动图指标与治疗前比较,差异均有统计学意义(P0.05);治疗后放疗组LVEF、Ea峰、Ea/Aa与治疗前比较,差异有统计学意义(P0.05),其余指标间差异无统计学意义(P0.05)。结论化疗、放疗、靶向治疗后乳腺癌患者的心功能均有变化。从超声心动图及心电图结果分析,放疗对心功能的影响较小,化疗及靶向治疗影响较大,且两者差异不明显,靶向治疗对心脏的收缩功能影响较大。
[Abstract]:Background and objective Cardiac function examination is mainly used in the diagnosis and follow-up of coronary heart disease, hypertension and other diseases. However, the damage of cardiac function in the treatment of malignant tumor has been paid more and more attention. The purpose of this study was to observe the changes of echocardiography and electrocardiogram after comprehensive treatment of breast cancer. Methods the results of electrocardiogram (ECG) and echocardiography (Echocardiography) in 160 patients with breast cancer admitted to the affiliated Cancer Hospital of Fudan University from July 2010 to July 2012 were analyzed retrospectively. According to the treatment methods, 75 patients were divided into chemotherapy group (75 cases), radiotherapy group (45 cases) and targeted treatment group (40 cases). The results of echocardiography and electrocardiogram before and after treatment were compared. Results after treatment, there were significant differences in heart rate (HR) and corrected ventricular repolarization time (QTc) among the three groups. The HR and QTc of chemotherapy group and targeted treatment group were compared with those before treatment. After treatment, left ventricular ejection fraction (LVEF), left ventricular short-axis shortening rate (LVEFN), left atrioventricular valve diastolic peak velocity (LVEFV) and left atrioventricular valve early diastolic peak velocity (LVEFV) were significantly higher than those in control group (P 0.05). The ratio of the peak velocity of left atrioventricular valve early diastolic to late diastolic peak velocity is E / A, the tissue velocity of left atrioventricular annulus in early diastolic phase is Ea peak, the tissue velocity of left atrioventricular annulus in early diastolic stage is higher than that in late left atrioventricular valve annulus. The ratio of tissue velocity of atrioventricular annulus and EA / Aa were compared. There was no significant difference between the two groups (P 0.05). There were significant differences in echocardiography indexes between the chemotherapy group and the target treatment group before treatment, and there was significant difference between the two groups before and after treatment, and there was no significant difference between the two groups before and after treatment, and there was no significant difference between the two groups before and after treatment, and there was no significant difference between the two groups before and after treatment. Conclusion the cardiac function of patients with breast cancer after chemotherapy, radiotherapy and targeted therapy all changed. The results of echocardiography and electrocardiogram showed that radiotherapy had little effect on cardiac function. The effects of chemotherapy and targeted therapy on cardiac contractile function were significant, and there was no significant difference between them.
【作者单位】：复旦大学附属肿瘤医院心肺功能室复旦大学上海医学院肿瘤学系;
【分类号】：R540.45;R737.9

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