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肿瘤治疗后,一定要照看好心脏!

2018-05-01 宋佳音 检验医学网

肿瘤和心血管疾病是我国主要的两种导致死亡的疾病。从06年起,肿瘤幸存者数目增加,但心血管的死亡率却逐年攀升,抗肿瘤治疗引起的一系列心血管系统疾病日益凸显。因此,肿瘤心脏病学(Onco-cardiology)应运而生。


作者:天津医科大学肿瘤医院检验科  宋佳音

肿瘤和心血管疾病是我国主要的两种导致死亡的疾病。从06年起,肿瘤幸存者数目增加,但心血管的死亡率却逐年攀升,抗肿瘤治疗引起的一系列心血管系统疾病日益凸显。因此,肿瘤心脏病学(Onco-cardiology)应运而生。

肿瘤对心血管的影响主要集中在两方面:一方面是直接对心肌毒性、血压、心肌缺血的直接损伤;另一方面是肿瘤患者生活方式改变,放、化疗等带来的间接损伤。癌症治疗引发的心血管系统疾病包括:肿瘤治疗相关性心功能不全、冠状动脉疾病、心脏瓣膜病、心率失常、高血压血栓疾病、周围血管病及卒中、肺动脉高压及心血管并发症9个方面。

2016《SCAI专家共识声明:心导管室内肿瘤心脏病患者的评估、管理及特殊考虑》中指出,多种化疗药物可增加心绞痛、急性心肌梗死风险。随着研究的不断深入,目前把肿瘤治疗相关的心脏毒性主要分为两大类,包括化学药物治疗和放射治疗相关的心脏毒性。其中化学药物治疗相关的心脏毒性还被分成两类:I型和II型。I型化学药物治疗相关心脏毒性指是经过治疗后,心肌细胞存在剂量依赖的心肌坏死和大面积不可逆损伤,这类毒性主要是由蒽环类药物引起。II型化学药物治疗相关心脏毒性主要是由分子靶向治疗药物引起的,这种损伤一般是可逆的,与药物剂量无关,也没有微观上的细胞坏死。

抗肿瘤治疗给病人带来的心血管疾病的损伤是十分值得重视的,进行肿瘤治疗相关心血管疾病的管理尤为重要,及时的进行心血管疾病风险预测、对高危患者给予适当的筛查与检测、因人而异注意预防性用药的启动时机,建立诊疗流程、做到早检测、早发现、早联合、早治疗,提高肿瘤放化疗及靶向治疗患者的长期生存率,改善肿瘤生存患者的生活质量。

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    2018-05-03 1209e435m98(暂无昵称)

    学习了.谢谢分享

    0

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    2018-05-02 一天没事干

    肿瘤和心血管的功能息息相关

    0

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    2018-05-02 天地飞扬

    了解一下.谢谢分享!

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1304091, encodeId=b5fb1304091a7, content=<a href='/topic/show?id=c5558298426' target=_blank style='color:#2F92EE;'>#肿瘤治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82984, encryptionId=c5558298426, topicName=肿瘤治疗)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=139a316, createdName=wumeihua88, createdTime=Thu May 03 11:06:00 CST 2018, time=2018-05-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=311521, encodeId=e76e311521d6, content=学习了.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Thu May 03 06:52:32 CST 2018, time=2018-05-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=311392, encodeId=b8753113923c, content=肿瘤和心血管的功能息息相关, beContent=null, objectType=article, channel=null, level=null, likeNumber=125, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2018/04/12/cd30eefc465f70dc4dad89bd57479781.jpg, createdBy=02be2318568, createdName=一天没事干, createdTime=Wed May 02 22:47:38 CST 2018, time=2018-05-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=311302, encodeId=93d731130280, content=了解一下.谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=122, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/12/23/2f51002e1349ccda5be11c1eea1e1e60.jpg, createdBy=a22097948, createdName=天地飞扬, createdTime=Wed May 02 12:42:13 CST 2018, time=2018-05-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=311200, encodeId=817c311200bf, content=好文献学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=147, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b5a62240667, createdName=张新亮1853311252142e2fm, createdTime=Wed May 02 07:08:48 CST 2018, time=2018-05-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=311132, encodeId=50c1311132bf, content=不错耶.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=3b2c1627329, createdName=owlhealth, createdTime=Wed May 02 06:18:22 CST 2018, time=2018-05-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=311066, encodeId=1fa8311066b6, content=肿瘤和心血管疾病是我国主要的两种导致死亡的疾病.从06年起.肿瘤幸存者数目增加.但心血管的死亡率却逐年攀升.抗肿瘤治疗引起的一系列心血管系统疾病日益凸显.因此.肿瘤心脏病学(Onco-cardiology)应运而生., beContent=null, objectType=article, channel=null, level=null, likeNumber=86, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7cJ6ejWUr2nIia8qOvAKNdLHr32Df6G8iaoaOx6pHaoiacwp26DaslxZHCGbibZhhCGven4rvmWP60GahtzgFjgCjR/0, createdBy=6b111703011, createdName=有备才能无患, createdTime=Tue May 01 22:53:18 CST 2018, time=2018-05-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=311039, encodeId=39b231103964, content=学习了.谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=86, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/10/23/557c1f19aaf5459a8405411e38903c4b.jpg, createdBy=dfc02088287, createdName=cscdliu, createdTime=Tue May 01 21:13:10 CST 2018, time=2018-05-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=311030, encodeId=611f311030e5, content=谢谢分享学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=115, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM7GibvIBibibnnnvpajk2stlDF5oichYahI6Bia8uxeTBFoPbdoHWebyXf9eal9FNgUF2lNcrwoZicM3BvQ/0, createdBy=a3742066385, createdName=戒馋,懒,贪, createdTime=Tue May 01 20:38:25 CST 2018, time=2018-05-01, status=1, ipAttribution=)]
    2018-05-02 张新亮1853311252142e2fm

    好文献学习了

    0

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    2018-05-02 owlhealth

    不错耶.学习了

    0

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    2018-05-01 有备才能无患

    肿瘤和心血管疾病是我国主要的两种导致死亡的疾病.从06年起.肿瘤幸存者数目增加.但心血管的死亡率却逐年攀升.抗肿瘤治疗引起的一系列心血管系统疾病日益凸显.因此.肿瘤心脏病学(Onco-cardiology)应运而生.

    0

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    2018-05-01 cscdliu

    学习了.谢谢

    0

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    2018-05-01 戒馋,懒,贪

    谢谢分享学习了

    0

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