弥漫性肺实质疾病过程中的肺动脉高压——目前的研究现状和未来的考虑。

Monika Szturmowicz, Aneta Kacprzak, Katarzyna Błasińska-Przerwa, Jan Kuś
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引用次数: 5

摘要

肺部疾病是肺动脉高压(PH)最常见的原因之一。PH的发展影响肺部疾病的病程,恶化临床症状和预后。根据最近的出版物,肺部疾病过程中的PH是遗传易感性患者的“实质”和血管病理学的结果。长期感染(尤其是病毒感染)可能是另一个促进因素。右心导管(RHC)是一种有创手术,是诊断PH的唯一客观方法。根据最新的建议,PH与间质性肺疾病共存的管理算法是基于RHC和肺功能检查结果。大多数患者在晚期肺部疾病过程中出现轻度PH。本组推荐对潜在肺部病理进行最佳治疗,并联合长期吸氧治疗。如果PH严重(平均静息肺动脉压(mPAP)≥35 mm Hg),则必须寻找PH的其他原因。pah特异性药物的使用应仅限于参与临床试验的严重PH患者。本文综述了各种无创方法(超声心动图、影像学检查、运动能力和脑利钠肽评估)在PH筛查过程中的价值,并讨论了近年来弥漫性肺实质疾病患者pah特异性药物的随机临床试验结果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Pulmonary hypertension in the course of diffuse parenchymal lung diseases - state of art and future considerations.

Lung diseases are one of the most frequent causes of pulmonary hypertension (PH). The development of PH influences the course of lung disease, worsening the clinical symptoms and prognosis. According to the most recent publications, PH in the course of lung diseases develops as a result of both "parenchymal" and vascular pathology, in the patients with genetic predisposition. Prolonged infection (especially viral one) may be an additional promoting factor. Right heart catheterization (RHC), which is an invasive procedure, is the only objective method of diagnosing PH. According to the latest recommendations, the management algorithm of PH and coexisting interstitial lung disease is based on RHC and the results of pulmonary function tests. Majority of the patients develop mild PH in the course of advanced lung disease. Best treatment of underlying lung pathology combined with long term oxygen treatment is recommended in this group. In case of severe PH (mean resting pulmonary artery pressure (mPAP) ≥ 35 mm Hg) the alternate cause of PH has to be sought. PAH-specific drugs use should be limited to patients with severe PH participating in clinical trials. In this review, the value of various non-invasive methods (echocardiography, radiological examination, exercise capacity and brain natriuretic peptides assessment) in the process of screening for PH is presented, and the results of recent randomized clinical trials with PAH-specific drugs in patients with diffuse parenchymal lung diseases are discussed.

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