摘要
心脏是一个对铁超载和心肌病特别敏感的器官，由于过度的心脏铁沉积导致大多数疾病死亡，如β地中海贫血。自由或松散结合的铁离子容易在铁和铁的状态之间循环，并催化产生高度反应性和毒性羟基自由基的哈伯-维斯反应。铁螯合剂（去铁氧胺、去铁哌酮和去铁西罗司）的治疗大大改善了铁负荷过重患者的心血管发病率和死亡率。此外，铁螯合剂已在已知或假定具有氧化应激作用（例如缺血/再灌注损伤）的各种心血管疾病中进行了研究，这些疾病也存在于体内铁含量正常的患者中。这些螯合剂的药效学和药动学特性对有效治疗至关重要。例如，临床上广泛使用但亲水性螯合剂去铁氧胺的质膜通透性较差，这意味着必须使用高浓度和临床上无法达到的浓度/剂量来获得心脏保护。因此，口服的小分子和亲脂性螯合剂更适合这一目的，特别是在没有系统性铁超载的状态下。除已在临床应用的药物外，芳酰肼铁螯合剂，即水杨醛异烟酸肼（sih）也取得了很好的效果。然而，使用经典的铁螯合剂与由于不加区别的铁耗尽而产生的毒性风险有关。因此，最近的研究集中在“掩盖的”前体细胞上，这些前体细胞在活性氧激活位点特异性之前对铁几乎没有或没有亲和力。
关键词: 心脏保护，铁螯合剂，铁前体，氧化应激，蒽环类，心脏毒性。
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