Department of Cardiology, National University Heart Centre Singapore, Singapore.
Singapore Med J. 2021 Jul;62(7):318-325. doi: 10.11622/smedj.2021089.
Chronic thromboembolic pulmonary hypertension (CTEPH) is a unique form of pulmonary hypertension resulting from obstruction of the pulmonary artery by fibrotic thromboembolic material, usually initiated by recurrent or incomplete resolution of pulmonary embolism. This distinct form of pulmonary hypertension is classified under Group 4 of the World Health Organization classification. Further investigations are usually initiated, with transthoracic echocardiography followed by right heart catheterisation and pulmonary angiography as the gold standard. Definitive treatment is usually in the form of surgical pulmonary endarterectomy. Inoperable CTEPH is medically treated with pharmacological agents such as phosphodiesterase Type 5 inhibitors, endothelin receptor antagonists, soluble guanylate cyclase stimulators and prostacyclin. Recent developments have made balloon pulmonary angioplasty a viable option as well.
慢性血栓栓塞性肺动脉高压（CTEPH）是一种由纤维性血栓栓塞物质阻塞肺动脉引起的独特形式的肺动脉高压，通常由复发性或不完全性肺栓塞缓解引起。这种特殊形式的肺动脉高压被归类为世界卫生组织分类的第 4 组。通常会进一步进行检查，首选方法是经胸超声心动图，然后是右心导管检查和肺动脉造影。明确的治疗方法通常是手术肺动脉内膜切除术。无法手术的 CTEPH 通过药物治疗，如磷酸二酯酶 5 抑制剂、内皮素受体拮抗剂、可溶性鸟苷酸环化酶刺激剂和前列环素。最近的发展使球囊肺动脉成形术成为一种可行的选择。
