摘要放射性心脏损伤(RIHD)是由胸部肿瘤放疗引起的常见迟发性不良反应之一.由于RIHD常处于亚临床状态,受照射后经过相当长潜伏期才出现症状,长期未引起临床注意.20世纪90年代,流行病学研究发现胸部肿瘤放疗增加了患者心脏病病死率,部分抵消了放疗产生的生存受益,RIHD才逐渐得到重视.随着近几十年放疗技术的改进,心脏受照剂量和体积明显下降,RIHD发病率有下降趋势.尽管如此,近期临床研究表明,在霍奇金淋巴瘤、肺癌及食管癌等恶性肿瘤放疗过程中,心脏仍会受到局部高剂量或全心低剂量的辐射,RIHD这一问题目前在临床上依然不可避免,胸部放疗患者长期心脏随访是必要的.该文对RIHD的临床表现、影响凶素、检查手段、预防治疗方法及近年来研究进展进行简要综述.

abstractsRadiation-induced heart disease (RIHD) is one of common late side effects derived by thoracic radiotherapy. RIHD is often subclinical and there is an extremely long clinical latent period between radiation therapy and the first clinical presentation of radiation injury, and it did not cause clinical attention for a long time. Until the 1990s, epidemiologic investigations demonstrate that thoracic cancer radiotherapy increased rates of cardiac mortality, RIHD has partly offset the survival benefit provided by adjuvant RT.Radiotherapy techniques has undergone many improvements over the last decades, these improvements decreased both the volume and dose of radiation delivered to the heart, seem to have decreased the incidence of RIHD. Nonetheless, recent studies indicate that the problem of RIHD may persist. For instance, patients with Hodgkin's Disease, lung cancer, and esophageal may still receive either a high dose of radiation to a small part of the heart or a lower dose to the whole heart in radiotherapy. Therefore, long-term cardiac followup of these patients is essential. This article briefly review the clinical presentations, influence factors, prevention and managements, diagnosis and study advances of RIHD.