Abstract：ObjectiveTo investigate the changes of ambulatory electrocardiography(AECG), QT dispersion(QTd), and heart rate variability(HRV) in patients with nasopharyngeal carcinoma(NPC) after radiotherapy. Methods Before and after 3 stages of radiotherapy with different doses(15-25 Gy, 35-45 Gy, and 55-65 Gy, respectively), 40 cases with NPC underwent AECG monitoring and were observed the changes of AECG, QTd, corrected QT dispersion(QTcd), and HRV indices of time domain and frequency domain caused by radiotherapy.ResultsBy comparing each index of AECG before and after 3 stages of radiotherapy in NPC patients, we found that: (i) there was no statistically significant difference in the incidences of supraventricular arrhythmia, ventricular arrhythmia, and ST-T changes(P＞0.05); between QTd and QTcd, there was no statistically significant difference(P＞0.05); in the HRV analysis, there was no statistically significant difference either in time domain indices of SDNN, rMSSD, and pNN50 or frequency domain indices of TP, LF, HF and LF/HF(P＞0.05). Pairedcomparison implied that VLF value after the 3 stages of radiotherapy was significantly lower than that before the treatment, and the difference was statistically significant(P＜0.05).Conclusion (i) The trend of the incidence ventricular arrhythmia was similar to that of ST-T changes, which showed an uptrend at a radiation dose of 15-25 Gy, a downtrend at a radiation dose of 35-45 Gy, and a strong uptrend at a radiation dose of 55-65 Gy. (ii) The indices of QTd and QTcd exhibited a downtrend at a radiation dose of 15-25 Gy, an uptrend at a radiation dose of 35-45 Gy, and recovered to pretherapeutic level at a radiation dose of 55-65 Gy. (iii) Among the HRV indices, the higher the radiation dose was, the more significantly VLF decreased. It hints that radiotherapy on NPC patients affects longterm regulating of body temperature, reninangiotensin system and humoral factors, enhances sympathetic nerve activity, influences sympathetic nervevagus equilibrium, and thus impacts the regulating of autonomic nerve and results in abnormal ECG.
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2014, Vol. 23 
