靶向药物治疗慢性血栓栓塞性肺动脉高压的合理性及疗效探讨  

Elaboration about Rationality and Effect of Targeting Drug Therapy in Chronic Thromboembolic Pulmonary Hypertension

作　　者：禹雪[1] 柳志红[1] 

机构地区：[1]中国医学科学院北京协和医学院国家心血管病中心阜外医院,北京100037

出　　处：《心血管病学进展》2017年第4期376-379,共4页Advances in Cardiovascular Diseases

基　　金：基金项目:肺血栓栓塞症诊疗规范及应用方案的精准化研究(2016YFC0905602)

摘　　要：慢性血栓栓塞性肺动脉高压(chronic thromboembolic pulmonary hypertension,CTEPH)是一种慢性进展性疾病,如果未经治疗,预后极差。2013年在法国尼斯召开的第五届世界肺动脉高压论坛会上将CTEPH归为第四大类肺动脉高压。由于CTEPH的症状因人而异且缺乏特异性,容易引起漏诊、误诊和延迟诊断。外科肺动脉血栓内膜剥脱术是唯一有可能治愈CTEPH的办法,但有一部分患者属于CTEPH分型中的Ⅲ型和Ⅳ型,即阻塞在亚段以下的远端或者非阻塞部位的小动脉发生血管重塑,使患者手术难度增大甚至不能进行外科手术,还有小部分患者接受外科手术后持续存在肺动脉高压。动脉性肺动脉高压和CTEPH在临床表现、病理特点和发病机制方面有交叉重叠部分,因此推动了有关靶向药物治疗CTEPH患者有效性和安全性的相关研究。Chronic thromboembolic pulmonary hypertension（CTEPH） is a progressive deadly disease with poor prognosis if not treated.It was classified as the Ⅳ type at the 2013 World Symposium on Pulmonary Hypertension in Nice,France.The optimal treatment is surgery with pulmonary endarterectomy.Nevertheless,a significant percentage of patients are deemed non-operable due to distal distribution of the disease and arteriopathy in the non-occluded areas.And another percentage of CTEPH patients remain pulmonary hypertension after pulmonary endarterectomy.The overlap in clinical presentation,pathological features and pathogenesis between pulmonary arterial hypertension（PAH） and CTEPH provides a compelling rationale for exploring the efficacy of PAH-targeted therapies in CTEPH.

关 键 词：靶向药物治疗 慢性血栓栓塞性肺动脉高压 血管重塑 

分 类 号：R544.1[医药卫生—心血管疾病]