动脉灌注化疗患者心电图改变64例分析

徐万里; 茅爱武; 金涛; 江谋应; 王金林; 严卫国

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动脉灌注化疗患者心电图改变64例分析

徐万里 , 茅爱武 , 金涛 , 江谋应 , 王金林 , 严卫国

文章导航 > 蚌埠医学院学报 > 2010, 35 > 8: (834-836)

引用本文:

Citation:

动脉灌注化疗患者心电图改变64例分析

1. 安徽省安庆市第一人民医院放射科, 246003;
2. 上海市长宁区同仁医院介入中心, 200050

作者简介: 徐万里(1963-),男,主治医师.

中图分类号: R979.1

Electrocardiogram changes caused by arterial infusion chemotherapy: an analysis of 64 cases

1. Department of Radiology, The First People's Hospital of Anqing, Anqing Anhui 246003;
2. Intervention Center, Shanghai Tongren Hospital of Changning District, Shanghai 200050, China
CLC number: R979.1

摘要: 目的:通过改变蒽环类抗肿瘤药物经肿瘤供养动脉给药模式的心电图观察,探讨蒽环类抗肿瘤药物的心脏毒性。方法:选择经病理学确诊的中晚期恶性肿瘤88例,化疗方案均为阿霉素+顺铂+氟尿嘧啶,随机分为A、B两组各44例。A组经肿瘤供养动脉主干单纯区域性灌注化疗56次;B组区域性和超选择性相结合、多靶点插管,合理灵活栓塞,小剂量用药和按血供比例灌注联合应用88次。观察2组灌注前及注药后10min、24h、48h的常规12导联心电图的变化。结果:88例患者插管前和插管时心电图均正常。经144次抗肿瘤药物灌注出现心电图改变64例,发生率为44.5%,其中A组心律失常发生率为58.1%,B组为24.2%,2组差异有统计学意义(P<0.01); ≥ 60岁组心律失常的发生率高于50~59岁组(P<0.05)。结论:经肿瘤供养动脉主干单纯区域性灌注化疗者心律失常发生率最高,提示该方法与静脉化疗阿霉素的心脏毒性作用无差异,且多发生于老年人,在介入治疗中应高度警惕。
- 抗肿瘤药 /
- 动脉灌注化疗 /
- 心脏毒性
Abstract: Objective: To discuss the cardiac toxicity of anthracycline by observing the electrocardiogram which recording the routs of administration by arteries providing nutrients to the tumor.Methods: Eighty-eight cases which were pathologically diagnosed as midadvanced malignant tumor were randomly divided into group A and group B (44 cases for each group).The chemotherapy regimen for both groups consisted of adriamycin + cisplatin + fluorouracil.In group A,regional perfusion through main coronary arteries of tumors was used alone for 56 times;in Group B,combined application of perfusion,regionally and super-selectively,with integration of multi-targeted intubation,reasonable and flexible embolization,low-dose of medication and perfusion according to proportion of blood supply,was conducted for 88 times.Infusion chemotherapy and embolization were conducted 144 times altogether.The conventional 12-lead ecg was recorded 10 minutes,24 hours and 48 hours after operation and drug injection.Results: Eighty-eight patients' electrocardiograms were normal during the process of pre-intubation and while-intubation.After conducting anticancer drug perfusion for 144 times,64 cases presented changes of electrocardiograms (44.5%),and the incidence rate of arrhythmia was 58.1% in group A.The difference between the two groups was statistically significant (P<0.01).The incidence of arrhythmia in patients aged above or equal to 60 was higher than that aged between 50 and 59 (P<0.05).Conclusions: Regarding to the two methods of interventional chemotherapy,the incidence of arrhythmia is higher in Group A.That implies that the cardiac toxicity initiated by the method used in Group A is not different from that initiated by the method of intravenous chemotherapy,and such effect occurs frequently among the elderly,which should be highly alerted to in the process of interventional chemotherapy.
- antineoplastic drugs /
- arterial infusion chemotherapy /
- cardiac toxicity

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动脉灌注化疗患者心电图改变64例分析

作者简介: 徐万里(1963-),男,主治医师.

1. 安徽省安庆市第一人民医院放射科, 246003;
2. 上海市长宁区同仁医院介入中心, 200050

收稿日期: 2009-04-20

关键词:

摘要: 目的:通过改变蒽环类抗肿瘤药物经肿瘤供养动脉给药模式的心电图观察,探讨蒽环类抗肿瘤药物的心脏毒性。方法:选择经病理学确诊的中晚期恶性肿瘤88例,化疗方案均为阿霉素+顺铂+氟尿嘧啶,随机分为A、B两组各44例。A组经肿瘤供养动脉主干单纯区域性灌注化疗56次;B组区域性和超选择性相结合、多靶点插管,合理灵活栓塞,小剂量用药和按血供比例灌注联合应用88次。观察2组灌注前及注药后10min、24h、48h的常规12导联心电图的变化。结果:88例患者插管前和插管时心电图均正常。经144次抗肿瘤药物灌注出现心电图改变64例,发生率为44.5%,其中A组心律失常发生率为58.1%,B组为24.2%,2组差异有统计学意义(P<0.01); ≥ 60岁组心律失常的发生率高于50~59岁组(P<0.05)。结论:经肿瘤供养动脉主干单纯区域性灌注化疗者心律失常发生率最高,提示该方法与静脉化疗阿霉素的心脏毒性作用无差异,且多发生于老年人,在介入治疗中应高度警惕。

English Abstract

Electrocardiogram changes caused by arterial infusion chemotherapy: an analysis of 64 cases

1. Department of Radiology, The First People's Hospital of Anqing, Anqing Anhui 246003;
2. Intervention Center, Shanghai Tongren Hospital of Changning District, Shanghai 200050, China

Received Date: 2009-04-20

Abstract: Objective: To discuss the cardiac toxicity of anthracycline by observing the electrocardiogram which recording the routs of administration by arteries providing nutrients to the tumor.Methods: Eighty-eight cases which were pathologically diagnosed as midadvanced malignant tumor were randomly divided into group A and group B (44 cases for each group).The chemotherapy regimen for both groups consisted of adriamycin + cisplatin + fluorouracil.In group A,regional perfusion through main coronary arteries of tumors was used alone for 56 times;in Group B,combined application of perfusion,regionally and super-selectively,with integration of multi-targeted intubation,reasonable and flexible embolization,low-dose of medication and perfusion according to proportion of blood supply,was conducted for 88 times.Infusion chemotherapy and embolization were conducted 144 times altogether.The conventional 12-lead ecg was recorded 10 minutes,24 hours and 48 hours after operation and drug injection.Results: Eighty-eight patients' electrocardiograms were normal during the process of pre-intubation and while-intubation.After conducting anticancer drug perfusion for 144 times,64 cases presented changes of electrocardiograms (44.5%),and the incidence rate of arrhythmia was 58.1% in group A.The difference between the two groups was statistically significant (P<0.01).The incidence of arrhythmia in patients aged above or equal to 60 was higher than that aged between 50 and 59 (P<0.05).Conclusions: Regarding to the two methods of interventional chemotherapy,the incidence of arrhythmia is higher in Group A.That implies that the cardiac toxicity initiated by the method used in Group A is not different from that initiated by the method of intravenous chemotherapy,and such effect occurs frequently among the elderly,which should be highly alerted to in the process of interventional chemotherapy.