董广通 张解玉 侯炜

    [摘要] 放疗是治疗胸部恶性肿瘤的主要手段之一，然其不可避免地会累及正常组织，肺是电离辐射中度敏感器官，因此极易造成放射性肺损伤，其主要表现为两个阶段，即早期的放射性肺炎期和后期不可逆转的放射性肺纤维化期，严重降低患者的生活质量，甚至发生呼吸衰竭而危及患者生命。放射性肺损伤还极大地限制了放射剂量，影响疗效，甚至使放疗被迫中断。本文就放射性肺损伤的发生机制、现代研究、预测体系、诊断、西医防治等方面作一综述。

    [关键词] 放射性肺损伤；研究进展；发生机制；现代研究；预测体系；诊断；防治

    [中图分类号] R818.74 [文献标识码] A [文章编号] 1673-7210(2018)10(c)-0024-05

    [Abstract] Radiotherapy is one of the main methods for treating malignant tumors of the chest. However， it is unavoidable that normal tissues are involved. The lung is a moderately sensitive organ of ionizing radiation and therefore can easily cause radiation-induced lung injury. It mainly manifests itself as two phases， namely the early stage of radiation pneumonitis periad and the irreversible radiation pulmonary fibrosis period， which seriously reduces the quality of the patient′s life and even causes respiratory failure and endangers the life of the patient. Radiation-induced lung injury greatly limits the radiation dose， affects the therapeutic effect， and even forces it to be interrupted. This article reviews the mechanisms of radiation-induced lung injury ......