生化及物理指标联合评估放射性心脏损伤的研究现状

The research status on biochemical and physical indicators: the joint assessment of radiationinduced heart disease

放射性心脏损伤是由胸部肿瘤放疗引起的常见不良反应,可明显增加冠状动脉疾病、心包疾病、瓣膜性心脏病及猝死的风险。研究发现,可通过血清肌钙蛋白I和心率变异性对放射性心脏损伤进行评价,但较难对其作出早期诊断。近年来的研究显示放射性心脏损伤的发生与心脏受照射体积和剂量有重要关系,因此可期待联合血清肌钙蛋白I、心率变异性及剂量体积直方图对放射性心脏损伤进行预测,并寻找早期预测胸部肿瘤放疗后心脏损伤有效的生化及物理指标,为临床治疗提供重要依据。

Radiation-induced heart disease(RIHD) proves to be one of the common adverse reactions due to radiotherapy for thoracic neoplasms. It can significantly increase the risk of coronary artery disease,pericardial disease,valvular heart disease and sudden death. It has been found by research that serum cardiac troponin I(cTnI) and heart rate variability(HRV) could be utilized in the evaluation of RIHD,but difficult to be used in early diagnosis. Recent studies have shown the important relationship between the incidence of RIHD and the volume and dose of heart irradiated.Therefore we intend to test serum cTnI,HRV and dose-volume histogram jointly to predict the disease,and explore effective biochemical and physical indicators furtherly for early prediction of heart injury due to radiotherapy for thoracic neoplasms,in order to provide important reference for clinical treatment.