【摘要】 索拉非尼作为多靶点酪氨酸激酶抑制剂，是晚期肝细胞癌、肾细胞癌及分化型甲状腺癌的核心治疗药物，但其心脏毒性显著限制临床应用，主要表现为高血压、心肌缺血、心力衰竭、心律失常及血栓/出血事件等，严重影响患者预后。本文深入探讨了索拉非尼诱导心脏毒性的分子机制，包括氧化应激与线粒体功能障碍、自噬失衡、核糖核酸(RNA)结合基序蛋白20(RBM20)介导的基因剪接异常、钙稳态失衡与心肌电生理异常等关键通路;同时系统总结了临床防治策略，涵盖高血压、心力衰竭等不良反应的预防、监测、干预与治疗措施。本研究为阐明索拉非尼心脏毒性的病理机制、优化临床用药安全性及改善患者生存质量提供了重要理论依据与实践参考。更多还原

【Abstract】 As a multi-target tyrosine kinase inhibitor,sorafenib is the core therapeutic drug for advanced hepatocellular carcinoma,renal cell carcinoma and differentiated thyroid cancer. However,its cardiotoxicity significantly limits clinical application,mainly manifests in hypertension,myocardial ischemia, heart failure, arrhythmia, and thrombosis/hemorrhage events,which seriously affect the patient’s prognosis. This paper deeply explores the molecular mechanisms of sorafenib inducing cardiotoxicity, including key pathways such as oxidative stress and mitochondrial dysfunction, autophagy imbalance, ribonucleic acid binding motif protein 20( RBM20) mediated gene splicing abnormalities,calcium homeostasis imbalance and myocardial electrophysiological abnormalities; at the same time, a systematic summary of clinical prevention and treatment strategies,covering monitoring and intervention measures for adverse reactions such as hypertension and heart failure,as well as research progress in experimental therapeutic drugs.更多还原