放疗剂量对鼻咽癌患者QT离散度、心率变异性时域、频域及心电图的影响

发布时间：2019-03-24 20:21

【摘要】：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(P0.05);窦性心律失常发生率明显低于放疗前(P0.05)。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。
[Abstract]:Objective to investigate the effects of different radiation doses on QT dispersion, time domain and frequency domain parameters of heart rate variability (HRV) and electrocardiogram (ECG) in patients with nasopharyngeal carcinoma (NPC). Methods Seventy-three patients with nasopharyngeal carcinoma received radiotherapy at doses of 15? 25,35? 45, 55? 65 Gy. The mean standard deviation (SDANN),) of (QTcd), NN interval standard deviation (QTcd), NN interval) after correction of QT dispersion (QTd), before and after radiotherapy was observed before and after radiotherapy. The mean (SDNN), NN interval standard deviation of (QTcd), NN interval was observed before and after radiotherapy. The root mean square of the mean value of adjacent NN intervals (the percentage of beats with r-MSSD,NN interval difference more than 50 ms) (p-NN50); Frequency domain index: very low frequency power (VLF), low frequency power (LF), high frequency power (HF), LF/HF, total power (TP), etc. Results compared with pre-treatment, the SDNN,r MSSD,p NN50,TP,VLF,LF,HF of patients treated with 15, 35, 55 Gy decreased, and decreased with the increase of radiation dose (P0.05). The incidence of sinus arrhythmias was significantly lower than that before radiotherapy (P0.05). Conclusion the changes of cardiac autonomic nerve function in patients with nasopharyngeal carcinoma can be closely monitored by monitoring the time-domain and frequency-domain parameters of QTd,QTcd,HRV in the course of radiotherapy, which can provide a certain basis for the evaluation of radiotherapy and prognosis.
【作者单位】：广西壮族自治区人民医院;
【基金】：广西壮族自治区卫生厅自筹经费科研课题(编号:Z2011428)
【分类号】：R739.63

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