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目的探讨麻醉类药物异氟醚和异丙酚对乳腺癌患者的QT离散度的效果,确定异氟醚和异丙酚对心肌功能的影响。方法随机选取2015年6月至2016年6月期间于开封市肿瘤医院接受表柔吡星化疗的乳腺癌患者100例,随机分为AI、AP组,每组各50例;同时选取未接受化疗的乳腺癌患者100例,随机分为CI、CP组,每组各50例。对AI组、CI组进行1.1%~1.6%异氟醚麻醉,AP组和CP组则进行异丙酚麻醉。以T1、T2、T3、T4、T5~T8、T9各时间点分别表示记录化疗前、化疗后第2周、气管插管前、即刻插管后、全麻给药后5、10、15、20 min、拔除气管导管10 min时各点的变化情况并记录QT间期(QTc)和QT间期延长的情况;在T1~7时进行QT离散度的较正后(QTcd)的计算。结果 AI组的T5~7时比T2的QT间期延长(P<0.05);AI组比AP组、CI组和CP组的T5~7时QT间期长(P<0.05)。在AI组和AP组中,T2~7时比T1时的QT离散度增加(P<0.05);AI组中T5~7时比T2时QT离散度增加(P<0.05)。QT间期延长发生率:在T6~8时,AI组比AP组、CI组和CP组的QT间期延长的发生率大(P<0.05)。结论接受表柔吡星作为辅助化疗手段的乳腺癌患者中QTcd可能会增加,异氟醚致使放大QT离散度并拉长QT间期,异丙酚对其没有明显影响。
Objective To investigate the effect of anesthetic drugs isoflurane and propofol on QT dispersion in patients with breast cancer and to determine the effect of isoflurane and propofol on myocardial function. Methods A total of 100 patients with breast cancer who underwent epirrandamycin chemotherapy in Kaifeng Cancer Hospital from June 2015 to June 2016 were randomly divided into AI group and AP group, 50 cases in each group. At the same time, 100 cases of breast cancer without chemotherapy 100 cases of breast cancer patients were randomly divided into CI, CP group, 50 cases in each group. 1.1% ~ 1.6% isoflurane anesthesia was performed in AI and CI groups, while propofol anesthesia was performed in AP and CP groups. At T1, T2, T3, T4, T5-T8 and T9, the time points before and after the chemotherapy were recorded before and after intubation, 20 min and the tracheal tube was removed for 10 min. The QT interval and QT interval were recorded. The QTcd was calculated after T1 ~ 7. Results The QT interval of T5 ~ 7 in AI group was longer than that of T2 (P <0.05). The QT interval of T5 ~ 7 in AI group was longer than that in AP group, CI group and CP group (P <0.05). In AI group and AP group, the QT dispersion at T2 ~ 7 o’clock was higher than that at T1 (P <0.05), while the QT dispersion at T5 ~ 7 o’clock was higher than that at T2 in AI group (P <0.05). The incidence of QT prolongation: At T6 ~ 8, the incidence of QT prolongation in AI group was higher than that in AP group, CI group and CP group (P <0.05). Conclusions QTcd may be increased in breast cancer patients treated with the use of Doxopyridon as adjuvant chemotherapy. Isoflurane induced QT dispersion and prolonged QT interval, and propofol had no significant effect on it.