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[目的]分析合并糖尿病的女性早期乳腺癌患者应用表阿霉素化疗后心脏自主神经系统活性变化。[方法]入选52例合并2型糖尿病、52例不合并2型糖尿病的女性早期乳腺癌患者,均行表阿霉素+环磷酰胺化疗。入选年龄匹配无乳腺癌的2型糖尿病女性患者50例作为糖尿病对照组。所有患者均行体格检查,包括身高、体重、血压、血常规及血脂、血糖、同步12导联心电图和24小时动态心电图检查。[结果]糖尿病患者在化疗前基线水平,SDNN、SDANN、RMSSD、p NN50、LF、HF明显降低,LF/HF比值明显升高;而在化疗后,糖尿病患者组与非糖尿病化疗组及糖尿病对照组比较,HRV各项指标的恶化更明显。[结论]对于合并糖尿病的早期乳腺癌患者,应用表阿霉素化疗后,明显的进一步加重了心脏自主神经系统损伤。
[Objective] To analyze changes of cardiac autonomic nervous system activity after epirubicin chemotherapy in women with early-stage breast cancer with diabetes mellitus. [Methods] Fifty-two women with early-stage breast cancer who had type 2 diabetes mellitus and 52 non-type 2 diabetes patients were treated with epirubicin plus cyclophosphamide. Fifty women with age-matched type 2 diabetes without breast cancer were enrolled as the diabetic control group. All patients underwent physical examination, including height, weight, blood pressure, blood and blood lipids, blood glucose, simultaneous 12-lead electrocardiogram and 24-hour ambulatory electrocardiogram. [Results] Before chemotherapy, the baseline levels of SDNN, SDANN, RMSSD, p NN50, LF and HF were significantly decreased and the LF / HF ratio was significantly increased in patients with diabetes mellitus. After chemotherapy, the patients with diabetes mellitus and non-diabetic chemotherapy and the diabetic controls Group comparison, HRV indicators of the deterioration of more obvious. [Conclusion] For patients with early stage breast cancer with diabetes mellitus, the application of epirubicin chemotherapy significantly aggravates cardiac autonomic nervous system injury.