DNA损伤及氧化应激在放射性心脏损伤中的作用

 放射性心脏损伤（RIHD）是放射诱导的一种进行性加重的疾病，它几乎影响心脏所有结构，从而产生一系列心脏并发症。从早期的无症状到慢性心力衰竭，常需几年至十几年时间。近年来文献报道心脏在正常组织耐受剂量控制下，常规胸部放疗所致的心脏损伤，特别是迟发型心肌损伤问题日益突出。本文综述了DNA损伤及氧化应激在RIHD的发生发展中的作用，现有研究认为RIHD可使心脏僵硬度增加、心肌收缩及舒张功能下降，引起心肌电生理紊乱、心律失常、心功能不全甚至猝死。但目前尚缺乏对RIHD的有效治疗，其根本原因在于对RIHD的原因及发病机制尚未完全阐明。

The role of DNA damage and oxidative stress in radiation-induced heart disease

The radiation-induced heart disease (RIHD) is a progressive disorder induced by radiation, which may take years or decades to manifest. It can affect various structures of the heart, with a series of cardiac complications. In recent years, it is reported that the heart damage caused by the conventional chest radiotherapy, especially the delayed type of myocardial injuries becomes very serious under the control of the normal tissue tolerance dose. The RIHD can increase the heart stiffness, decrease the myocardial systolic and diastolic functions, resulting in the myocardial electrophysiological dysfunction, the arrhythmia, the heart failure and the sudden death. At present, there is still a lack of effective treatment for the RIHD, the basic reason is that the causes and pathogenesis of the RIHD promoted chronic heart failure from early asymptomatic condition have not been fully clarified. This paper reviews the role of the DNA damage and the oxidative stress in the RIHD to help the prevention and treatment of the RIHD.