儿童癌症远期生存与代谢综合征

Long-term survival and metabolic syndrome in childhood cancer

随着全球医疗技术的快速发展，儿童癌症的临床诊治及研究取得了长足进步。儿童癌症生存率大幅提高，儿童癌症幸存者的生活质量开始受到重视。大量研究报道儿童癌症幸存者远期代谢综合征发病率高，特别是经颅照射腹部照射或者全身照射的患儿发生代谢综合征的风险更高。代谢综合征是多种代谢异常同时聚集在同一个体的病理状态，显著增加心血管疾病风险。儿童癌症幸存者远期代谢综合征的发病机制尚未阐明，但已明确与抗癌治疗后激素缺乏、药物或放射治疗损害、内皮功能紊乱等因素密切相关。因此，重视儿童癌症幸存者代谢综合征的早期诊断、早期防治，鼓励癌症幸存者改善饮食习惯和增加运动达到理想的体重，以降低代谢综合征、心血管疾病的发病率具有重要的临床意义。

Along with the rapid development of global medical technology, great progress has been made in clinical diagnosis and treatment of childhood cancer,hence childhood cancer survival rate is increasing markedly. The clinicians have become concerned about life quality of childhood cancer survivors. A number of studies reported that long-term childhood cancer survivors are at increased risk of developing metabolic syn-drome,especially after cranial irradiation,abdomal irradiation,or total body irradiation. Metabolic syndrome is a variety of metabolic abnormalities commonly clustered together in a condition of the same individual,which sig-nificantly increases risk of cardiovascular diseases. Though the etiology of the metabolic syndrome in cohorts of childhood cancer survivors has not been elucidated,the predisposing factors have been identified as the lack of hormones after cancer treatment,damage from medicine or radiation therapy,endothelial dysfunction and so on. Accordingly,early diagnosis of metabolic syndrome is of great importance with medical interventions,such as encouraging cancer survivors to improve dietary habit and enhance exercise to achieve ideal weight,and to subse-quently decrease the risk of metabolic syndrome and cardiovascular events.