Hida Wataru, Tun Ye, Kikuchi Yoshihiro, Okabe Shinichi, Shirato Kunio
Health Administration Center, Department of Informatics on Pathophysiology, Tohoku University Graduate School of Information Sciences, Sendai, Japan.
Respirology. 2002 Mar;7(1):3-13. doi: 10.1046/j.1440-1843.2002.00366.x.
In patients with chronic obstructive pulmonary disease (COPD), pulmonary hypertension (PH) is associated with a worse prognosis. Recently, information has been increasing concerning the cellular and molecular aspects of the pathophysiology of PH in COPD. The most striking finding is the role of vascular endothelial cells and endogenous mediators released by these cells. Endothelial cell-dependent relaxation is impaired in COPD patients with PH. Moreover, vascular remodelling in these patients is mainly responsible for irreversible PH in advanced COPD. Smoking cessation will slow down the progression of the disease process and may prevent the development of PH in COPD. The timing of initiation of long-term oxygen therapy is important for the effective management of PH in COPD. Research on therapeutic agents for the effective treatment of PH is still needed in the management aspect of patients with COPD. This review focuses on the recent advances in our understanding of the pathophysiology and treatment of PH in COPD.
在慢性阻塞性肺疾病（COPD）患者中，肺动脉高压（PH）与较差的预后相关。最近，关于COPD中PH病理生理学的细胞和分子方面的信息不断增加。最显著的发现是血管内皮细胞及其释放的内源性介质的作用。伴有PH的COPD患者存在内皮细胞依赖性舒张功能受损。此外，这些患者的血管重塑是晚期COPD中不可逆PH的主要原因。戒烟将减缓疾病进程，并可能预防COPD中PH的发生。开始长期氧疗的时机对于COPD中PH的有效管理很重要。在COPD患者的管理方面，仍需要对有效治疗PH的治疗药物进行研究。本综述重点关注我们对COPD中PH病理生理学和治疗的最新认识进展。
