Diagnosis and management of pulmonary arterial hypertension.
Diagnosis and management of pulmonary arterial hypertension.
复制标题
DOI：
10.1155/2011/845864
复制
发表时间：
2011
影响因子：
4.3
通讯作者：
Klinger JR
中科院分区：
文献类型：
--
作者：
Houtchens J;Martin D;Klinger JR
肺动脉高压是一种罕见的疾病，当患者最初出现时，需要高度怀疑才能诊断。最初的症状可能是非特异性的，包括疲劳和轻度呼吸困难等症状。一旦怀疑疾病，超声心动图用于估计肺动脉（PA）压力，并排除PA压力升高的次要原因，如左心疾病。右心导管插入术和血管扩张剂激发对于正确评估肺血流动力学和确定患者是否可能从血管扩张剂治疗中获益至关重要。在病理学上，该疾病的特征在于远端肺动脉和小动脉循环的有害重构，这导致肺血管阻力增加。在过去的十五年里，三种不同类别的药物已被批准用于治疗肺动脉高压。这些包括前列腺素类、内皮素受体拮抗剂和磷酸二酯酶-5抑制剂。
Pulmonary arterial hypertension is a rare disease, which requires a high index of suspicion to diagnose when patients initially present. Initial symptoms can be nonspecific and include complaints such as fatigue and mild dyspnea. Once the disease is suspected, echocardiography is used to estimate the pulmonary arterial (PA) pressure and to exclude secondary causes of elevated PA pressures such as left heart disease. Right heart catheterization with vasodilator challenge is critical to the proper assessment of pulmonary hemodynamics and to determine whether patients are likely to benefit from vasodilator therapy. Pathologically, the disease is characterized by deleterious remodeling of the distal pulmonary arterial and arteriolar circulation, which results in increased pulmonary vascular resistance. In the last fifteen years, medications from three different classes have been approved for the treatment of pulmonary arterial hypertension. These include the prostanoids, endothelin receptor antagonists, and phosphodiesterase-5 inhibitors.