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放射性心脏损伤(radiation-induced heart disease,RIHD)是指对胸廓、胸壁及纵隔肿瘤进行放射治疗时对心脏造成的损伤,这种损伤往往导致心脏出现病理变化及相应的临床表现,包括急性心包炎、心肌和心包纤维化、心脏传导功能异常等[1-3],尤其是伴有心脏衰竭、冠心病等心血管基础疾病的患者,放疗会加重原有心脏疾病[4],严重降低了晚期肿瘤患者的生活质量[2]。这类患者在行放疗时心脏不可避免地会受到照射,Stewart等[5]研究显示,RIHD的发病率与心脏所受照射剂量和体积相关,随照射剂量和体积的增加,RIHD的发病率明显升高,Darby等[6]研究认为,当心脏体积V45为60%时,放射性心包炎的发病率为1%~5%;当V55>60%时其发病率可达25%~50%。何宏涛等[7]研究发现,全心V60≥5.04%时,急性RIHD的发病率为93.33%,当V60<5.04%时,急性RIHD的发病率降为70.3%。遗憾的是目前还没有有效的方法阻止RIHD的发生和进展[3]。因此,阐明RIHD发生的生理、病理机制,对RIHD的治疗及预防起着重要作用,稳定的RIHD动物模型,对进行其相关研究起着关键作用,为了更好地选择适合RIHD模型造模的动物及方法,本文对RIHD造模动物的特点、造模方法及模型的具体应用作以下综述。
放射性心脏损伤动物模型的研究进展
Progress in animal model of radiation-induced heart disease
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摘要: 目前我国肿瘤发病率已超越心血管疾病跃居第一位,随着外科及放化疗技术的提升与发展,肿瘤患者的生存周期已得到大幅度提高。与之相反的是肿瘤在治疗过程中所引起的近期和远期并发症却已成为影响患者生存质量的主要因素,尤其是胸廓、胸壁及纵隔肿瘤(如霍奇金淋巴瘤、乳腺癌等)在进行放疗时所引起的心脏的近期及远期不良反应,成为该类肿瘤患者死亡的重要原因之一。而稳定的动物模型是临床前研究放射性心脏损伤的基础,为放射性心脏损伤的预防和治疗提供大量实验依据。为此该文对历年来研究者常用建立放射性心脏损伤模型的造模动物及其特点、造模方法的改进与发展、模型的具体应用进行综述。Abstract: The incidence of cancer has surpassed the cardiovascular disease as the first one in China. With the improvement and development of surgical techniques and chemo-radiotherapy, the patient's survival time has been prolonged greatly. On the contrary, long-term and recent complications caused during the tumors treatment process have become one of the main factors which severely influence the quality of life of the patients. Cardiovascular recent and long-term adverse reaction caused by radiation has become the major cause of death in cancer patients especially for thoracic, chest wall and mediastinal tumor(such as Hodgkin′s lymphoma, breast cancer, etc.). And stable animal model is the basis of clinical research of radioactive heart damage which can provide a large number of experiments for the prevention and treatment of radioactive heart damage. For this purpose, the article reviewed the animal model of radioactive heart damage and its characteristics, the improvement and development of the modelling methods, and the concrete application of the model.
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Key words:
- Radiation injuries /
- Heart injuries /
- Models, animal
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