[没有并发症的患者肺动脉高血压的向治疗]
Hans Klose1, Lars Harbaum2, Manuel J Richter3
1Abteilung für Pneumologie, II. Medizinische Klinik und Poliklinik, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland.
Pneumologie (Stuttgart, Germany)
|November 14, 2023
概括
2022年欧洲指南建议在低风险的肺动脉高血压 (PAH) 患者中预先进行双重治疗,并考虑在高风险患者中进行三重治疗. 在随访期间,治疗调整的指导是风险评估.
科学领域:
- 心脏病学 心脏病学
- 肺部病理学 肺部病理学
- 药理学 药理学是指药理学的学科.
背景情况:
- 2022年欧洲心脏病学会 (ESC) 和欧洲呼吸学会 (ERS) 的指导方针提供了针对肺高血压的最新治疗策略.
- 肺动脉高血压 (PAH) 管理需要根据患者表现和风险分层而定制的方法.
研究的目的:
- 总结2022年ESC/ERS指南对治疗肺动脉高血压 (PAH) 的建议.
- 专注于没有明显并发症的PAH患者的治疗策略,包括异常性PAH,遗传性PAH,药物/毒素诱导的PAH和结缔组织疾病相关的PAH.
主要方法:
- 审查2022年ESC/ERS关于肺高血压的指南.
- 基于对短期死亡风险的多维评估,分析治疗建议.
- 对PAH患者的初始和后续治疗决策的总结.
主要成果:
- 建议在低风险和中等风险的PAH患者进行前期双重组合治疗 (PDE5抑制剂和ERA).
- 对于高风险或中高风险的PAH患者,应考虑使用三重疗法,包括静脉注射前环素.
- 如果不达到风险目标,建议进行连续的补充疗法或切换药物 (例如,PDE5抑制剂到sGC刺激剂).
结论:
- 风险分层对于指导PAH的初始和持续治疗决策至关重要.
- 目前的指导方针提倡早期组合治疗,以改善PAH患者的治疗结果.
- 治疗升级策略对于在PAH管理中实现和保持低风险概况至关重要.
相关概念视频
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