免疫检查点抑制剂相关心肌炎的心血管磁共振研究进展  

Research progress on cardiovascular magnetic resonance in immune checkpoint inhibitor-associated myocarditis

作　　者：祁汉雄 张丹 叶兆祥 Hanxiong Qi;Dan zhang;Zhaoxiang Ye(Department of Radiology,Tianjin Medical University Cancer Institute&Hospital,National Clinical Research Center for Cancer,Tianjin’s Clinical Research Center for Cancer,State Key Laboratory of Druggability Evaluation and Systematic Translational Medicine,Tianjin Key Laboratory of Cancer Prevention and Therapy,Tianjin 300060,China)

机构地区：[1]天津医科大学肿瘤医院放射科,国家恶性肿瘤临床医学研究中心,天津市恶性肿瘤临床医学研究中心,药物成药性评价与系统转化全国重点实验室,天津市“肿瘤防治”重点实验室,天津市300060

出　　处：《中国肿瘤临床》2024年第24期1280-1284,共5页Chinese Journal of Clinical Oncology

基　　金：国家重点研发计划(编号:2021YFC2500400、2021YFC2500402);天津市医学重点学科(专科)建设项目(编号:TJYXZDXK-010A)资助。

摘　　要：免疫检查点抑制剂(immune checkpoint inhibitors,ICIs)在提高机体对肿瘤细胞的杀伤能力时,也会导致多种心血管毒性的出现。其中,免疫检查点抑制剂相关心肌炎(ICI-associated myocarditis,ICI-M)的发病率及死亡率最高,这也是临床诊疗中的关键难题。心血管磁共振(cardiovascular magnetic resonance,CMR)是无创评估心脏结构、功能和组织特性的“金标准”,近年来国内外指南已将其作为评价ICI-M的重要工具。本文基于国内外近期指南和国内外研究成果,对ICI-M的病理学机制、诊断标准、CMR的相关研究进展及临床应用价值进行综述。Although immune checkpoint inhibitors(ICIs)enhance the immune system’s capacity to destroy tumor cells,they can also induce a range of toxic responses that lead to cardiovascular damage.Among these adverse effects,ICI-associated myocarditis(ICI-M)has the highest morbidity and mortality rates,presenting a significant challenge in clinical practice.Cardiovascular magnetic resonance(CMR)is regarded as the"gold standard"for noninvasive assessment of cardiac structure,function,and tissue characteristics.While this imaging technique has advanced rapidly in recent years,with both domestic and international guidelines recognizing it as a crucial tool for evaluating ICIM.This article provides a comprehensive overview of the pathological mechanisms underlying ICI-M,its diagnostic criteria,and the latest research developments in CMR and its clinical applications;it also discusses the most recent domestic and international guidelines and research findings.

关 键 词：免疫检查点抑制剂 心肌炎 心血管磁共振 

分 类 号：R542.21[医药卫生—心血管疾病] R445.2[医药卫生—内科学]