[慢性血栓栓塞性肺高血压 - 隐藏的疾病]
Gábor Kolodzey1, László Balogh1, Judit Barta1
11 Debreceni Egyetem, Általános Orvostudományi Kar, Klinikai Központ, Kardiológiai Klinika Debrecen, Móricz Zs. krt. 22., 4032 Magyarország.
Orvosi hetilap
|November 30, 2025
概括
慢性血栓栓塞性肺高血压 (CTEPH) 是一种隐藏的疾病,往往是晚诊断的. 一般医生的早期识别对于及时转诊和改善这种可治愈的肺高血压形式的结果至关重要.
科学领域:
- 心脏病学 心脏病学
- 肺部病理学 肺部病理学
- 血管医学 血管医学
背景情况:
- 慢性血栓栓塞性肺高血压 (CTEPH) 由未解决的肺栓塞引起,导致血管重塑和增加肺抵抗力.
- 未经治疗的CTEPH会发展为右心力衰竭,非特异性症状往往会导致诊断延迟.
- CTEPH是一种罕见但可能可治愈的疾病,需要及时干预.
研究的目的:
- 提供CTEPH流行病学,病理生理学,诊断挑战和治疗选择的最新概述.
- 强调全科医生和内科医生在早期检测CTEPH中的关键作用.
- 突出当前的治疗策略及其对患者结果的影响.
主要方法:
- 进行了叙事文学评论.
- 主要来源包括2022年ESC/ERS指南,最近的欧洲和国际注册表和当代审查.
- 该审查侧重于CTEPH的流行病学,病理生理学,诊断和治疗.
主要成果:
- 肺栓塞后CTEPH的发病率为2-4%,实际患病率可能更高.
- 诊断的延迟是显著的,患者在症状出现18-24个月后到达专门中心.
- 肺内关节切除术可以治愈中心病变;气球血管整形和riociguat为无法手术的病例提供了选择.
结论:
- 诊断CTEPH仍然具有挑战性,这强调了需要提高医生意识的必要性.
- 一般医生在识别CTEPH时至关重要,他们可以通过识别呼吸障碍和右心力衰竭等症状来识别症状.
- 早期诊断和基于证据的管理显著改善了CTEPH患者的生活质量和生存率.
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