门脉性肺动脉高压发病机制及治疗的最新研究进展  

Latest Research Progress in Pathogenesis and Treatment of Portopulmonary Hypertension

作　　者：徐杰[1] 史阳阳 孙凯[1] XU Jie;SHI Yangyang;SUN Kai(Department of Emergency,the First Affiliated Hospital with Nanjing Medical University,Nanjing 210029,China)

机构地区：[1]南京医科大学第一附属医院急诊科,南京210029

出　　处：《医学综述》2021年第13期2503-2508,共6页Medical Recapitulate

基　　金：国家自然科学基金(81871544);江苏省科技项目(BK20181493)。

摘　　要：门脉性肺动脉高压(PPHTN)是门静脉高压患者的一种常见并发症,其发病机制尚不明确,个体间存在显著差异,病死率较高。PPHTN的发病机制可能与血流高动力循环、血管活性介质失调、遗传变异、高炎症反应等因素相关,但其具体直接致病因素仍有待进一步研究。目前,针对PPHTN的特异性扩血管药物的随机对照试验较少,对于轻度PPHTN患者,临床上多单独或联合应用扩血管药物改善患者症状;而对于中、重度PPHTN患者,特异性扩血管药物联合肝移植治疗是否是最佳方案还有待进一步探究。未来,更多致病通路的发现将为PPHTN的治疗提供新方向。Portal pulmonary hypertension(PPHTN)is a common complication in patients with portal hypertension.Because the pathogenesis is not clear,and there are significant differences between individuals,the mortality rate is high.At present,the pathogenesis is mainly considered to be related to a variety of factors such as high blood dynamic circulation,dysregulation of vasoactive mediators,genetic variation,and high inflammatory response,but the direct pathogenic factors need to be further studied.At present,there are few randomized controlled trials of specific vasodilators targeting PPHTN.In clinic,for patients with mild PPHTN,single or combined vasodilators are mostly used to improve symptoms,while for patients with moderate to severe PPHTN,whether the combination of specific vasodilator drugs with liver transplantation is the optimal approach remains to be further explored.In the future,the discovery of more pathogenetic pathways will provide new directions for the treatment of PPHTN.

关 键 词：门脉性肺动脉高压 炎症反应 血管活性介质失调 肝移植 

分 类 号：R544.1[医药卫生—心血管疾病]