Division of Pulmonary and Critical Care Medicine, Northwestern University, Chicago, Illinois, USA.
Curr Opin Pulm Med. 2012 Mar;18(2):138-43. doi: 10.1097/MCP.0b013e32834f2093.
Pulmonary hypertension is a common complication seen in patients with advanced chronic obstructive pulmonary disease (COPD). Information related to the true prevalence, implications for functional outcomes, pathogenesis, and therapeutic options available has been lacking. The purpose of this review is to summarize some exciting findings from the last several years that address these holes in our knowledge.
Several recent studies have explored the prevalence and the functional implications of pulmonary hypertension for patients with COPD. These highlight the importance of clearly defining pulmonary hypertension that can be quite heterogeneous in this patient population. Furthermore, the concept that pulmonary hypertension in COPD is merely driven by hypoxic vasoconstriction has been called into question by several lines of investigation that suggest a much more complex pathogenesis potentially occurring independently of hypoxemia. Finally, there has been much interest in exploring pulmonary hypertension-specific therapies in patients with COPD, but available data to support their use are limited.
The recent findings summarized here have expanded our knowledge regarding this important comorbidity in patients with advanced COPD. We now know that pulmonary hypertension is common, has clear effects on both morbidity and mortality, and has a complex pathophysiology that we are only beginning to understand.
肺动脉高压是晚期慢性阻塞性肺疾病（COPD）患者常见的并发症。关于其真实患病率、对功能结局的影响、发病机制以及现有治疗选择的相关信息一直缺乏。本文旨在总结过去几年中一些令人兴奋的发现，以填补我们在这方面的知识空白。
最近的几项研究探讨了肺动脉高压在 COPD 患者中的患病率及其对功能的影响。这些研究强调了明确界定肺动脉高压的重要性，因为在这一患者群体中，肺动脉高压具有很大的异质性。此外，肺动脉高压在 COPD 中仅仅由缺氧性血管收缩驱动的概念受到了质疑，因为有几条研究线索表明，潜在的发病机制可能独立于低氧血症而发生，要复杂得多。最后，人们对探索 COPD 患者的肺动脉高压特异性治疗方法产生了浓厚的兴趣，但支持其使用的现有数据有限。
这里总结的最新发现扩展了我们对晚期 COPD 患者这一重要合并症的认识。我们现在知道，肺动脉高压很常见，对发病率和死亡率都有明显影响，而且具有复杂的病理生理学，我们才刚刚开始理解。
