肺动脉高压的治疗进展

肺动脉高压是以肺小动脉痉挛、内膜增生与重构为主要特征的一组临床与病理生理综合征，最终导致肺循环阻力进行性增加、右心功能衰竭直至死亡。肺动脉高压传统治疗效果差，不能延缓疾病进程。然而近年来肺动脉高压发病机制研究与选择性作用于肺循环血管舒张药物的研发，已经证实能够改善疾病预后。外科手术与介入治疗尚缺乏临床应用依据，基因治疗在今后较长时间内仍处于临床前研究阶段。肺动脉高压至今尚无理想治疗手段，本文将对各种治疗方法进行评述，侧重药物治疗进展。

Advance in Current Treatment of Pulmonary Arterial Hypertension

Pulmonary arterial hypertension(PAH)affects vascular spasm,proliferation and remodeling in small pulmonary arteries,and results in right ventricular failure and death due to a progressive increase in pulmonary vascular resistance.Therapeutic approach can't be recommended in a universal manner for all PAH patients.Conventional medical treatments show low efficacy in the treatment of PAH as they do not affect underlying disease processes.Recent advances in the physiopathogenesis of PAH and the emergence of new drugs,with selective vasodilatory effects on the pulmonary vascular bed,contribute to improving these patients' survival.The rationale for surgical/interventional therapies in PAH is rarely used in clinics,and genetic treatment will be still in preclinical tests for a long time.To date,there is no treatment that can be considered ideal for the management of PAH.We will perform a review of the therapeutic management of PAH,with emphasis on the current medical arm.