Dadlani Gul H, Sosa Phil, Cobb Harrison, Akshatha Akshatha
aJohns Hopkins All Children's Heart Institute, St Petersburg, Florida bDepartment of Pediatrics, Morsani College of Medicine, University of South Florida, Tampa, Florida, USA.
Curr Opin Cardiol. 2016 Jan;31(1):78-87. doi: 10.1097/HCO.0000000000000243.
The article is intended to provide an overview of the most current modalities for the diagnosis and management of pulmonary hypertension in the pediatric population.
The WHO has recently updated the classification for pulmonary hypertension to include an expanded range of pediatric disease cohorts. We continue to gain knowledge of traditional pulmonary hypertension therapies (phosphodiesterase inhibitors, endothelin-receptor antagonists, and prostanoids) and remain optimistic that new therapeutic modalities [cyclic guanosine monophosphate (cGMP) stimulators, oral prostacyclins, and gene therapy] will lead to improved outcomes in pediatric patients.
Pediatric pulmonary hypertension is a heterogeneous disorder that has the potential to improve in some cases as children grow throughout childhood. Utilization of dedicated multidisciplinary teams of medical providers is necessary to deliver the highest level of medical care to this complex patient population. Ongoing development of enhanced screening protocols, novel disease-specific therapeutic targets, and comprehensive registries will hopefully lead to improved morbidity and mortality in the future.
本文旨在概述儿科人群肺动脉高压诊断和管理的最新方法。
世界卫生组织最近更新了肺动脉高压的分类,纳入了范围更广的儿科疾病队列。我们持续深入了解传统的肺动脉高压治疗方法(磷酸二酯酶抑制剂、内皮素受体拮抗剂和前列环素),并对新的治疗方式[环磷酸鸟苷(cGMP)刺激剂、口服前列环素和基因治疗]能改善儿科患者的预后仍持乐观态度。
儿科肺动脉高压是一种异质性疾病,在某些情况下,随着儿童在整个童年期成长,病情有可能改善。需要由专业的多学科医疗团队为这一复杂患者群体提供最高水平的医疗服务。不断完善筛查方案、确定新的疾病特异性治疗靶点以及建立综合登记系统,有望在未来降低发病率和死亡率。