Pulmonary embolism
Pulmonary embolism
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DOI：
10.1038/nrdp.2018.28
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发表时间：
2018-05-17
影响因子：
81.5
通讯作者：
Klok, Frederikus A.
中科院分区：
文献类型：
--
作者：
Huisman, Menno V.;Barco, Stefano;Klok, Frederikus A.
肺栓塞（PE）是由栓子引起的，栓子起源于静脉血栓，进入并阻塞肺动脉。PE是最危险的静脉血栓栓塞形式，未经诊断或治疗的PE可能是致命的。急性PE与右室功能障碍相关，可导致心律失常、血流动力学衰竭和休克。此外，PE存活的个体可能会出现PE后综合征，其特征是肺动脉慢性血栓残留，持续的右心室功能障碍，生活质量下降和/或慢性功能限制。近年来，在急性PE的诊断和治疗管理方面取得了几项重要的改进，例如引入了一种简化的疑似PE诊断算法，以及III期试验证明了直接口服抗凝剂在静脉血栓栓塞的急性和长期治疗中的价值。未来的研究应着眼于解决新的治疗方案（例如，纤溶增强剂），改进预测长期并发症和确定个体患者最佳抗凝治疗参数的方法，并更好地了解pe后综合征。
Pulmonary embolism (PE) is caused by emboli, which have originated from venous thrombi, travelling to and occluding the arteries of the lung. PE is the most dangerous form of venous thromboembolism, and undiagnosed or untreated PE can be fatal. Acute PE is associated with right ventricular dysfunction, which can lead to arrhythmia, haemodynamic collapse and shock. Furthermore, individuals who survive PE can develop post-PE syndrome, which is characterized by chronic thrombotic remains in the pulmonary arteries, persistent right ventricular dysfunction, decreased quality of life and/or chronic functional limitations. Several important improvements have been made in the diagnostic and therapeutic management of acute PE in recent years, such as the introduction of a simplified diagnostic algorithm for suspected PE as well as phase III trials demonstrating the value of direct oral anticoagulants in acute and extended treatment of venous thromboembolism. Future research should aim to address novel treatment options (for example, fibrinolysis enhancers) and improved methods for predicting long-term complications and defining optimal anticoagulant therapy parameters in individual patients, and to gain a greater understanding of post-PE syndrome.