Widimský J
Eur J Respir Dis. 1986 Mar;68(3):161-6.
Vasodilatory treatment decreases exercise dyspnoea in the majority of patients with primary pulmonary hypertension, due to an increase of cardiac output. Pulmonary vascular resistance declines, but pulmonary arterial pressure decreases only in some patients. Basically, the cause of the difference among "responders" and "non-responders" to this type of therapy is not known. The presence of hypertensive vascular changes in the pulmonary circulation may be a possible explanation for a lack of positive response to vasodilator treatment. This treatment is not without side effects and needs careful clinical and haemodynamic evaluation. Calcium antagonists are probably the drug of choice. There are few studies about the effect of vasodilatory treatment of "secondary" pulmonary hypertension due to chronic lung diseases, with differing results. Whether vasodilatory treatment can improve the life expectancy in patients with primary or secondary pulmonary hypertension is not yet known. The quality of life seems, however, to be improved, at least in some patients.
血管舒张治疗可降低大多数原发性肺动脉高压患者的运动性呼吸困难，这是由于心输出量增加所致。肺血管阻力下降，但仅部分患者的肺动脉压降低。基本上，对于这类治疗，“反应者”和“无反应者”存在差异的原因尚不清楚。肺循环中高血压性血管变化的存在可能是对血管舒张治疗缺乏阳性反应的一个可能解释。这种治疗并非没有副作用，需要仔细的临床和血液动力学评估。钙拮抗剂可能是首选药物。关于慢性肺部疾病所致“继发性”肺动脉高压的血管舒张治疗效果的研究较少，结果各异。血管舒张治疗能否改善原发性或继发性肺动脉高压患者的预期寿命尚不清楚。然而，生活质量似乎至少在部分患者中有所改善。
