Rosenzweig Erika B, Barst Robyn J
Columbia University College of Physicians & Surgeons, New York, NY 10032, USA.
Curr Opin Pediatr. 2008 Jun;20(3):288-93. doi: 10.1097/MOP.0b013e3282ff5fdc.
With rapid advances in the understanding and treatment of pulmonary arterial hypertension, navigating the pediatric literature becomes challenging. A comprehensive review of the most recent literature over the past year on available and emerging novel therapies as well as an approach to target pediatric populations will provide insight into the current management of pediatric pulmonary hypertension patients.
Recent therapeutic advances have significantly improved the prognosis for children with pulmonary arterial hypertension. Pediatric pulmonary arterial hypertension continues to be a serious condition, however, which is extremely challenging to manage. There are also new target groups, such as those with sickle cell disease, congenital diaphragmatic hernia and Eisenmenger syndrome who may be candidates for treatments previously used for idiopathic pulmonary arterial hypertension patients.
The data in children are often limited to case reports as many of those described here. Thus, the reader needs to be cautious about the interpretation of such small uncontrolled studies. While many of these data support the rationale for using novel agents for children with pulmonary arterial hypertension, further controlled and well designed studies are necessary to assess the true impact of these agents on various subgroups of children with pulmonary arterial hypertension.
随着肺动脉高压在认识和治疗方面的迅速进展,梳理儿科文献变得具有挑战性。对过去一年中有关现有和新兴新型疗法的最新文献以及针对儿科人群的方法进行全面综述,将有助于深入了解儿科肺动脉高压患者的当前管理情况。
近期的治疗进展显著改善了患有肺动脉高压儿童的预后。然而,儿科肺动脉高压仍然是一种严重的疾病,管理起来极具挑战性。此外,还有一些新的目标群体,如镰状细胞病、先天性膈疝和艾森曼格综合征患者,他们可能是以前用于特发性肺动脉高压患者的治疗方法的候选对象。
儿童中的数据通常限于病例报告,就像这里描述的许多情况一样。因此,读者在解释这类小型非对照研究时需要谨慎。虽然这些数据中的许多都支持将新型药物用于患有肺动脉高压儿童的基本原理,但仍需要进一步进行对照良好且设计完善的研究,以评估这些药物对患有肺动脉高压儿童的各个亚组的真正影响。