Hegewald Matthew J, Elliott C Gregory
Division of Pulmonary and Critical Care Medicine Intermountain Medical Center, University of Utah School of Medicine, Salt Lake City, UT.
Division of Pulmonary and Critical Care Medicine Intermountain Medical Center, University of Utah School of Medicine, Salt Lake City, UT.
Chest. 2009 Feb;135(2):536-537. doi: 10.1378/chest.08-1515.
Pulmonary hypertension is an important complication of COPD. A small subset of patients with COPD have severe pulmonary hypertension (PH) that is out of proportion to the mild increase in pulmonary arterial pressure observed commonly. Severe PH associated with COPD is associated with increased morbidity and mortality. Treatment options in this group of patients are limited with no conclusive evidence of benefit when drugs approved for treatment of pulmonary arterial hypertension are used. We describe a patient with severe PH associated with COPD who improved clinically and hemodynamically when treated with inhaled iloprost. The improvement was sustained for 2 years. Severe PH in patients with COPD needs to be recognized and novel treatment approaches considered.
肺动脉高压是慢性阻塞性肺疾病（COPD）的重要并发症。一小部分COPD患者患有严重的肺动脉高压（PH），其严重程度与通常观察到的肺动脉压轻度升高不成比例。与COPD相关的严重PH与发病率和死亡率增加相关。在这组患者中，治疗选择有限，使用批准用于治疗肺动脉高压的药物时，没有确凿的获益证据。我们描述了一名患有与COPD相关的严重PH的患者，在接受吸入伊洛前列素治疗后，临床和血流动力学均有改善。这种改善持续了2年。COPD患者的严重PH需要得到认识，并考虑新的治疗方法。
