慢性阻塞性肺疾病相关肺动脉高压：病例研究及文献回顾。
Pulmonary Hypertension in COPD: A Case Study and Review of the Literature.
机构信息
Department of Pulmonary & Critical Care Medicine, University of Maryland School of Medicine, Baltimore, MD 21201, USA.
出版信息
Medicina (Kaunas). 2019 Aug 2;55(8):432. doi: 10.3390/medicina55080432.
Pulmonary hypertension (PH) is a frequently encountered complication of chronic obstructive pulmonary disease (COPD) and is associated with worsened clinical symptoms and prognosis. The prevalence of PH-COPD is not concretely established as classification criteria vary historically, but the presence of severe disease out of proportion to underlying COPD is relatively rare. Right heart catheterization, the gold standard in diagnosis of PH, is infrequently performed in COPD, and the overlap in the clinical symptoms of PH and COPD presents diagnostic challenges. Proven treatments are limited. Trials exploring the use of vasodilator therapy in this patient group generally demonstrate improvements in hemodynamics accompanied by worsening gas exchange without clearly demonstrated improvements in clinically meaningful outcomes. In-depth workup of underlying pulmonary hypertension and use of pulmonary vasodilator medications may be appropriate on an individual basis. We present a case study and a review and discussion of the pertinent literature on this topic.
肺动脉高压（PH）是慢性阻塞性肺疾病（COPD）的常见并发症，与临床症状恶化和预后不良相关。PH-COPD 的患病率尚未具体确定，因为分类标准在历史上有所不同，但与潜在 COPD 不成比例的严重疾病相对较少。右心导管检查是 PH 诊断的金标准，但在 COPD 中很少进行，PH 和 COPD 的临床症状重叠带来了诊断挑战。已证实的治疗方法有限。在该患者群体中探索血管扩张剂治疗的试验通常显示血液动力学改善，同时伴有气体交换恶化，而在临床上有意义的结局方面没有明显改善。在个体基础上深入研究潜在的肺动脉高压并使用肺血管扩张药物可能是合适的。我们提出了一个病例研究，并对该主题的相关文献进行了回顾和讨论。
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