Olschewski H, Behr J, Bremer H, Claussen M, Douschan P, Halank M, Held M, Hoeper M M, Holt S, Klose H, Krüger S, Lange T J, Reichenberger F, Skowasch D, Ulrich S, Wilkens H, Seeger W
Dtsch Med Wochenschr. 2016 Oct;141(S 01):S57-S61. doi: 10.1055/s-0042-114528. Epub 2016 Oct 19.
The 2015 European Guidelines on Pulmonary Hypertension did not cover only pulmonary arterial hypertension (PAH) but also some aspects of pulmonary hypertension (PH) associated with chronic lung disease. The European Guidelines point out that the drugs currently used to treat patients with PAH (prostanoids, endothelin receptor antagonists, phosphodiesterase-5 inhibitors, sGC stimulators) have not been sufficiently investigated in other forms of PH. Therefore, the European Guidelines do not recommend the use of these drugs in patients with chronic lung disease and PH. This recommendation, however, is not always in agreement with medical ethics as physicians feel sometimes inclined to treat other form of PH which may affect quality of life and survival of these patients in a similar manner. To this end, it is crucial to consider the severity of both PH and the underlying lung disease. In June 2016, a Consensus Conference organized by the PH working groups of the German Society of Cardiology (DGK), the German Society of Respiratory Medicine (DGP) and the German Society of Pediatric Cardiology (DGPK) was held in Cologne, Germany, to discuss open and controversial issues surrounding the practical implementation of the European Guidelines. Several working groups were initiated, one of which was dedicated to the diagnosis and treatment of PH in patients with chronic lung disease. The recommendations of this working group are summarized in the present paper.
2015年欧洲肺动脉高压指南不仅涵盖了肺动脉高压（PAH），还涉及了与慢性肺病相关的肺动脉高压（PH）的一些方面。欧洲指南指出，目前用于治疗PAH患者的药物（前列环素、内皮素受体拮抗剂、磷酸二酯酶-5抑制剂、可溶性鸟苷酸环化酶刺激剂）在其他形式的PH中尚未得到充分研究。因此，欧洲指南不建议在慢性肺病合并PH的患者中使用这些药物。然而，这一建议并不总是符合医学伦理，因为医生有时倾向于以类似方式治疗可能影响这些患者生活质量和生存的其他形式的PH。为此，考虑PH和潜在肺病的严重程度至关重要。2016年6月，由德国心脏病学会（DGK）、德国呼吸医学学会（DGP）和德国儿科心脏病学会（DGPK）的PH工作组组织的一次共识会议在德国科隆举行，以讨论围绕欧洲指南实际实施的开放性和有争议的问题。启动了几个工作组，其中一个专门致力于慢性肺病患者PH的诊断和治疗。本文总结了该工作组的建议。
