Cerro Maria Jesus Del, Abman Steven, Diaz Gabriel, Freudenthal Alexandra Heath, Freudenthal Franz, Harikrishnan S, Haworth Sheila G, Ivy Dunbar, Lopes Antonio A, Raj J Usha, Sandoval Julio, Stenmark Kurt, Adatia Ian
La Paz Children's Hospital, Madrid, Spain.
Pulm Circ. 2011;1(2):286-298. doi: 10.4103/2045-8932.83456.
Current classifications of pulmonary hypertension have contributed a great deal to our understanding of pulmonary vascular disease, facilitated drug trials, and improved our understanding of congenital heart disease in adult survivors. However, these classifications are not applicable readily to pediatric disease. The classification system that we propose is based firmly in clinical practice. The specific aims of this new system are to improve diagnostic strategies, to promote appropriate clinical investigation, to improve our understanding of disease pathogenesis, physiology and epidemiology, and to guide the development of human disease models in laboratory and animal studies. It should be also an educational resource. We emphasize the concepts of perinatal maladaptation, maldevelopment and pulmonary hypoplasia as causative factors in pediatric pulmonary hypertension. We highlight the importance of genetic, chromosomal and multiple congenital malformation syndromes in the presentation of pediatric pulmonary hypertension. We divide pediatric pulmonary hypertensive vascular disease into 10 broad categories.
目前的肺动脉高压分类对我们理解肺血管疾病、推动药物试验以及增进我们对成年幸存者先天性心脏病的认识有很大帮助。然而,这些分类并不容易适用于儿科疾病。我们提出的分类系统牢牢基于临床实践。这个新系统的具体目标是改进诊断策略、促进适当的临床研究、增进我们对疾病发病机制、生理学和流行病学的理解,并指导实验室和动物研究中人类疾病模型的开发。它也应该是一种教育资源。我们强调围产期适应不良、发育异常和肺发育不全的概念是儿科肺动脉高压的致病因素。我们突出遗传、染色体和多种先天性畸形综合征在儿科肺动脉高压表现中的重要性。我们将儿科肺动脉高压性血管疾病分为10大类。