放射性心脏损伤的研究进展  

Research Advances of Radiation-induced Heart Disease

作　　者：刘群惠(综述) 刘志勇(审校) LIU Qun-hui;LIU Zhi-yong(School of Clinical Medicine,Shandong Second Medical University,Weifang 261000,China;Shandong University Qilu Hospital Dezhou Hospital,Dezhou 253000,China)

机构地区：[1]山东第二医科大学临床医学院,潍坊261000 [2]山东大学齐鲁医院德医院,德州253000

出　　处：《微循环学杂志》2024年第1期92-97,共6页Chinese Journal of Microcirculation

摘　　要：放射治疗是目前胸部恶性肿瘤的重要治疗手段,但其所带来的放射性心脏损伤(RIHD)已成为放疗患者非肿瘤性死亡的主要原因之一,严重削弱了其临床获益。RIHD的病理生理机制复杂,涉及内皮细胞炎症损伤、氧化应激、DNA损伤、心肌纤维化等。放射损伤最终可能会累及心脏的所有结构,包括心包、冠状动脉、传导系统、心肌、心脏瓣膜等。肿瘤患者放疗过程中应联合心电图、心肌损伤标志物、影像学等检查常规监测心脏功能,以便早期发现RIHD。治疗方面目前尚无确切有效的措施,主要策略包括控制危险因素、减少放疗剂量、药物治疗等。本文对RIHD最近研究成果进行综述以供临床参考。Radiotherapy is currently an important treatment for thoracic malignancies,but its associated radiation-induced heart disease(RIHD)has become one of the major causes of non-tumour death in patients treated with radiotherapy,severely diminishing its clinical benefit.The pathophysiological mechanisms of RIHD are complex,involving inflammatory damage to endothelial cells,oxidative stress,DNA damage,myocardial fibrosis,and so on.Radiation injury may eventually damage all structures of the heart,including the pericardium,coronary arteries,conduction system,myocardium,and heart valves.Cardiac function should be routinely monitored during radiotherapy in oncology patients in combination with ECG,markers of myocardial injury,and imaging for early detection of RIHD.There are no definitive and effective measures for treatment,and the main strategies include control of risk factors,reduction of radiotherapy dose,and pharmacological treatment.In this article,we review the recent research findings on RIHD for clinical reference.

关 键 词：放射性心脏损伤 胸部恶性肿瘤 放射治疗 

分 类 号：R730.55[医药卫生—肿瘤] R541.9[医药卫生—临床医学]