肺动脉高血压的管理
Jason Weatherald1, Rhea A Varughese1, Jonathan Liu2
1Division of Pulmonary Medicine, Department of Medicine, University of Alberta, Edmonton, Canada.
Seminars in respiratory and critical care medicine
|June 27, 2023
概括
肺动脉高血压 (PAH) 的管理包括向治疗和风险评估. 目前的指导方针建议在低风险患者中进行组合治疗,而在伴随疾病患者中建议采用个性化方法.
科学领域:
- 心血管医学 心血管医学
- 肺部医学 肺部医学
- 药理学 药理学是指药理学的学科.
背景情况:
- 肺动脉高血压 (PAH) 是一种严重的血管疾病,影响肺和右心室.
- 这种PAH的特征是动脉逐渐重塑,抗性增加,生存率降低.
研究的目的:
- 审查目前肺动脉高血压 (PAH) 的治疗策略.
- 概述现代管理方法,整合风险评估和组合疗法.
主要方法:
- 审查已批准的PAH治疗方法,针对氧化,内甲素-1和前环素通路.
- 基于患者风险和并发症的PAH管理现行指南的分析.
主要成果:
- 已批准的PAH疗法包括PDE-5抑制剂,甘酸环酶刺激剂,内甲素受体对抗剂和前环素类比剂/对抗剂.
- 指导方针建议在低风险/中等风险的PAH中进行双重口服治疗,在高风险患者中使用肠道前环素.
- 对于具有并发性疾病的PAH患者,个人化,单剂方法是首选的.
结论:
- 风管理需要进行多维风险评估,以指导治疗选择.
- 经验丰富的中心的多学科团队对于最佳的PAH患者护理至关重要.
- 尽管取得了进展,但仍需要新的治疗方法来逆转PAH并改善长期结果.
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