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[肺动脉高压的筛查与诊断。关于欧洲心脏病学会和呼吸病学会最新指南的评论]

[Screening and diagnosis of pulmonary arterial hypertension. Comments regarding the latest guidelines from the European Societies of Cardiology and of Pulmonology].

作者信息

de Groote Pascal, Lamblin Nicolas, Launay David, Bervar Jean-François, Hachulla Eric

机构信息

CHRU, Hôpital Cardiologique, Service de Cardiologie C, Pôle de Cardiologie et Maladies Vasculaires, 59037 Lille cedex, Centre de Compétences HTAP. Université de Lille 2, France.

出版信息

Presse Med. 2010 Jun;39 Suppl 1:1S16-21. doi: 10.1016/S0755-4982(10)70003-8.

Abstract

Transthoracic echocardiogram is the best tool for the screening of PH. When PH is suspected, the diagnosis must be confirmed by a right heart catheterization, and a vasoreactivity testing with NO must be performed in all cases of pulmonary arterial hypertension. Next steps for the work-up include: defining the type of PH (precapillary or postcapillary) and etiology, assessing prognostic factors, initiating therapy (if required) and following up the patient (particularly response to therapy). Routine screening is warranted in systemic sclerosis, HIV infection and portal hypertension. All patients with PH must be referred to a reference or a competence center for PH.

摘要

经胸超声心动图是筛查肺动脉高压(PH)的最佳工具。当怀疑有PH时,必须通过右心导管检查来确诊,并且在所有肺动脉高压病例中都必须进行一氧化氮(NO)血管反应性测试。进一步检查的后续步骤包括:确定PH的类型(毛细血管前性或毛细血管后性)和病因,评估预后因素,启动治疗(如果需要)以及对患者进行随访(尤其是对治疗的反应)。对于系统性硬化症、HIV感染和门静脉高压症,进行常规筛查是必要的。所有PH患者都必须转诊至PH参考中心或专业中心。

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