Post-tuberculosis pulmonary hypertension: a case of global disparity in health care.
Post-tuberculosis pulmonary hypertension: a case of global disparity in health care.
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结核病后肺动脉高压：全球卫生保健差异的一个案例。
DOI：
10.1016/s2214-109x(22)00042-0
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发表时间：
2022
期刊：
影响因子：
--
通讯作者：
Lui,JustinK
中科院分区：
文献类型：
--
作者：
Walsh,KathleenF;Lui,JustinK
结核病是一种贫困疾病，对最弱势群体的影响尤为严重。 Nicolas Menzies 及其同事（2021 年 12 月）1 强调了结核病后续护理中持续存在的不平等现象。在世卫组织高负担国家，结核病后遗症与显着的发病率和估计寿命减少超过 16 年有关。结核后后遗症最常发生在结核分枝杆菌引起的肺组织破坏后的肺部，包括慢性阻塞性肺病、肺动脉高压、支气管扩张和继发性非结核感染等疾病，所有这些疾病都需要适当的筛查和诊断以指导后续治疗。由于存在一些诊断挑战，肺动脉高压仍然是一种尚未得到充分研究的结核后肺部后遗症。肺动脉高压的定义是静息平均肺动脉压超过20毫米汞柱，需要侵入性右心导管插入术才能诊断。 2 该程序需要专门的设备，以及经过培训的药物管理和血流动力学监测人员，而这些在资源有限的环境中并不容易获得。随后，肺动脉高压的治疗由心肺血流动力学的测量决定。大约80%的肺动脉高压患者生活在低收入和中等收入国家，该病主要影响65岁以下的人群。 3 肺结核的患病率
Tuberculosis is a disease of poverty, disproportionately affecting the most vulnerable populations. Nicolas Menzies and colleagues (December, 2021) 1 highlight the persistence of inequity in tuberculosis follow-up care. Post-tuberculosis sequelae are associated with significant morbidity and an estimated reduction of more than 16 life-years in WHO high burden countries. Post-tuberculosis sequelae, most often occurring in the lungs following the destruction of lung tissue caused by M tuberculosis, include diseases such as chronic obstructive lung disease, pulmonary hypertension, bronchiectasis, and secondary nontuberculosis infections, all of which require appropriate screening and diagnosis to guide subsequent therapies.Pulmonary hypertension remains an understudied post-tuberculosis lung sequela because of several diagnostic challenges. Pulmonary hypertension is defined by a resting mean pulmonary artery pressure of more than 20 mm Hg, which requires invasive right heart catheterisation to diagnose. 2 Specialised equipment is needed for this procedure, as well as trained staff for medication administration and haemodynamic monitoring, which are not readily available in resource-limited settings. The management of pulmonary hypertension is subsequently dictated by measures of cardiopulmonary haemodynamics. Approximately 80% of people with pulmonary hypertension live in low-income and middle-income countries, and the disease mainly affects people younger than 65 years. 3 While the prevalence of pulmonary