Perrin E, Gasche-Soccal P M
Service de pneumologie, HUG, 1211 Genève 14.
Rev Med Suisse. 2005 Nov 16;1(41):2652-3, 2655-7.
Chronic thromboembolic pulmonary hypertension (CTEPH) is caused by obstruction of large pulmonary arteries by acute or recurrent emboli, organisation of these clots, and vascular remodeling of occluded as well as non-occluded peripheral arteries. Up to 4% of patients surviving from an acute embolic event will eventually develop chronic pulmonary hypertension. Major goals of the diagnostic work-up of pulmonary hypertension include the determination of its cause, the evaluation of its functional and haemodynamic repercussions, and if thromboembolic disease is present, the exact mapping of the pulmonary vascular bed obstruction. Pulmonary endarterectomy is the treatment of choice for selected patients. Therapeutic alternatives include lung or heart-lung transplantation, pulmonary angioplasty and pharmacological treatment with pulmonary vasodilators.
慢性血栓栓塞性肺动脉高压（CTEPH）由急性或反复发生的栓子阻塞大肺动脉、这些血栓的机化以及闭塞和未闭塞外周动脉的血管重塑引起。急性栓塞事件存活的患者中，高达4%最终会发展为慢性肺动脉高压。肺动脉高压诊断检查的主要目标包括确定其病因、评估其功能和血流动力学影响，以及如果存在血栓栓塞性疾病，精确描绘肺血管床阻塞情况。肺动脉内膜剥脱术是部分患者的首选治疗方法。治疗选择包括肺移植或心肺移植、肺血管成形术以及使用肺血管扩张剂的药物治疗。
