摘要
肺动脉高压（pulmonary hypertension，PH）是慢性阻塞性肺疾病（chronic obstructive pulmonary disease，COPD）的一个重要合并症。COPD患者出现PH时临床上并无特异症状。目前，右心导管检查仍是诊断PH的金标准．多普勒超声心动图则为无刨性诊断PH的最佳方法，核磁共振在诊断COPD合并PH中的作用仍需进行研究。长期氧疗是目前惟一证明能稳定、减轻PH进展的方法，但肺动脉压罕见恢复正常。肺血管结构的改变也依然存在。不建议使用传统的血管扩张剂，如钙离子拮抗剂、血管紧张素Ⅱ拮抗剂来治疗COPD相关的PH。新型血管扩张剂，如前列环素、磷酸二酯酶5抑制剂、内皮素受体拮抗剂在COPD相关PH中的作用缺乏大规模的随机对照研究，目前的少量研究结果令人失望。
Pulmonary hypertension（PH） is a common complication of chronic obstructive pulmonary disease（COPD）. Symptoms due to PH are difficult to differentiate from the clinical picture of COPD. Right heart catheterization is the gold standard for the diagnosis of PH. Doppler echocardiography is by far the best method for the noninvasive diagnosis of PH. The role of magnetic resonance imaging in the diagnosis strategy of PH in COPD must be determined. Long-term oxygen administration is the only treatment that slows down the progression of PH in COPD. Nevertheless, with this treatment pulmonary artery pressure rarely returns to normal values and the structural abnormalities of pulmonary vessels remain unaltered. Conventional vasodilators （i. e. calcium channel blockers,angiotensin inhibitors） are not recommended. There are no large scale randomized controlled studies about the role of new pulmonary vasodilators （i. e. prostacyclin, phosphodiesterase-5 inhibitor,endothelin-receptor antagonist） in PH in COPD. At present, the results of a small amount of studies are disappointed.
出处
《国际呼吸杂志》
2009年第6期326-330,共5页
International Journal of Respiration
关键词
慢性阻塞性肺疾病
肺动脉高压
诊断
治疗
Chronic obstructive pulmonary diseasE
Pulmonary hypertension
Diagnosis
Treatment
