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肺动脉高压:药物及非药物治疗方法

Pulmonary Hypertension: Pharmacological and Non-Pharmacological Therapies.

作者信息

Tsai Jason, Malik Shaista, Tjen-A-Looi Stephanie C

机构信息

Susan Samueli Integrative Health Institute, College of Health Sciences, University of California-Irvine, Irvine, CA 92617, USA.

出版信息

Life (Basel). 2024 Oct 4;14(10):1265. doi: 10.3390/life14101265.

Abstract

Pulmonary hypertension (PH) is a severe and chronic disease characterized by increased pulmonary vascular resistance and remodeling, often precipitating right-sided heart dysfunction and death. Although the condition is progressive and incurable, current therapies for the disease focus on multiple different drugs and general supportive therapies to manage symptoms and prolong survival, ranging from medications more specific to pulmonary arterial hypertension (PAH) to exercise training. Moreover, there are multiple studies exploring novel experimental drugs and therapies including unique neurostimulation, to help better manage the disease. Here, we provide a narrative review focusing on current PH treatments that target multiple underlying biochemical mechanisms, including imbalances in vasoconstrictor-vasodilator and autonomic nervous system function, inflammation, and bone morphogenic protein (BMP) signaling. We also focus on the potential of novel therapies for managing PH, focusing on multiple types of neurostimulation including acupuncture. Lastly, we also touch upon the disease's different subgroups, clinical presentations and prognosis, diagnostics, demographics, and cost.

摘要

肺动脉高压(PH)是一种严重的慢性疾病,其特征是肺血管阻力增加和血管重塑,常导致右心功能不全和死亡。尽管这种疾病是进行性的且无法治愈,但目前针对该疾病的治疗主要集中在多种不同的药物和一般支持性治疗上,以控制症状和延长生存期,范围从更专门针对肺动脉高压(PAH)的药物到运动训练。此外,有多项研究在探索新型实验性药物和治疗方法,包括独特的神经刺激,以帮助更好地控制该疾病。在此,我们提供一篇叙述性综述,重点关注当前针对多种潜在生化机制的肺动脉高压治疗方法,这些机制包括血管收缩剂 - 血管舒张剂和自主神经系统功能失衡、炎症以及骨形态发生蛋白(BMP)信号传导。我们还关注新型治疗方法在管理肺动脉高压方面的潜力,重点关注包括针灸在内的多种神经刺激类型。最后,我们还涉及该疾病的不同亚组、临床表现和预后、诊断、人口统计学以及成本。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/95cd/11509317/deca777674eb/life-14-01265-g001.jpg

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