蒽环类药物心脏毒性防治药物研究进展

蒽环类药物包括阿霉素、表阿霉素、柔红霉素和阿克拉霉素等，广泛地用于治疗血液系统恶性肿瘤和实体肿瘤，如急性白血病、淋巴瘤、乳腺癌、胃癌、软组织肉瘤和卵巢癌等。蒽环类药物可以与其他化疗药物及分子靶向药物联合应用，以蒽环类药物为基础的联合治疗通常是一线治疗的标准方案。蒽环类药物的抗瘤谱广，抗瘤作用强，疗效确切，但是可以引起脱发、骨髓抑制和心脏毒性等毒副反应。针对骨髓抑制可采用造血刺激因子(G-CSF、EPO、TPO等)进行防治，而心脏毒性是蒽环类药物最严重的毒副反应。临床研究和实践观察均显示蒽环类药物导致的心脏毒性呈进展性和不可逆性，特别是初次使用蒽环类药物就可能造成心脏损伤，因此早期监测和积极预防蒽环类药物引起的心脏毒性显得尤为重要，已经引起临床上的高度重视，制定了蒽环类药物心脏毒性防治指南。本研究对目前蒽环类药物心脏毒性的防治药物进行综述。 

Research progress on cardio-protective drug for preventing anthracycline cardiotoxicity

Anthracyclines, which include doxorubicin, epirubicin, daunorubicin, and aclarubicin, are widely used chemotherapeutic agents for treating hematologic and solid tumors, such as acute leukemia, lymphoma, breast cancer, gastric cancer, soft tissue sarcomas, and ovarian cancer. Anthracyclines can be combined with other chemotherapeutics and molecular targeted drugs for cancer treatment. The combination of anthracyclines with other chemotherapeutic drugs is usually the standard of first-line treatment. Anthracyclines are efficacious and potent agents with broad antitumor effects. However, these drugs may cause adverse reactions, such as hair loss, myelotoxicity, and cardiotoxicity. Hematopoietic stimulating factors, such as granulocyte colony-stimulating factor, erythropoietin, and thrombopoietin, can be used to control myelotoxicity. However, cardiotoxicity is the most serious anthracycline side effect. Clinical study results and practical observations indicate that the anthracycline cardiotoxicity is usually progressive and irreversible, especially after the first use of the drug, which may particularly cause heart damage. Therefore, the early detection and prevention of anthracycline-induced cardiotoxicity are important and have already gained considerable attention in clinical applications. Relevant experts from the China Society of Clinical Oncology and Hematology Branch of the Chinese Medical Association prepared the guidelines for the prevention and cure of anthracycline-induced cardiotoxicity in 2013. The authors reviewed the effective drugs currently used to prevent and cure anthracycline cardiotoxicity.