放射性心脏损伤的研究进展

放射治疗可以提高许多恶性肿瘤患者的生存率，但辐射诱发的副作用，特别是胸部照射可能引发的心脏、血管和肺的损伤，导致组织重塑，这个复杂的过程是由大量相互作用的分子信号组成，包括细胞因子、趋化因子和生长因子。而炎性反应、内皮细胞功能障碍、血栓形成、器官功能障碍以及最终的心脏衰竭是一种病理实体“放射性心脏损伤”，与纵隔淋巴瘤、乳腺癌、肺癌和食管癌等放射治疗有关，是胸部肿瘤放疗后发病率和死亡率的主要来源之一。而长期潜伏期是RIHD不被广泛研究的原因，但随着肿瘤患者生存时间延长，放疗所致的迟发性心脏损伤的问题越发突出。除了老年患者，年轻患者治疗后RIHD发生率也在逐渐增高，因此RIHD越来越受到关注和重视。本文将对放射性心脏损伤的类型、发病机制、影响因素的相关研究进行综述。

Research Progress of Radiation-indnced Heart Disease

Radiotherapy(RT) improves the survival of many cancer patients, but there are some adverse effects of radiation. One of them is radiation-induced heart disease(RIHD). In case of chest irradiation, RIHD can affect the heart, blood vessels and lungs, with consequent tissue remodelation. This complex process is composed of a large number of interacting molecular signals, including cytokines, chemokines and growth factors. Inflammation, endothelial cell dysfunction, thrombogenesis, organ dysfunction and ultimate failing of the heart occur as the pathological entity-RIHD which is associated with radiation therapy for mediastinal lymphoma, breast, lung and oesophageal cancers, etc. And is the major source of morbidity and mortality. The long latent period is the reason why RHID is not extensively studied. With the prolonged survival of cancer patients, RIHD is growing concerned, especially in younger patients. In this review article, we discuss the pathogenesis, the type of injury and influencing factors.