基础医学与临床 ›› 2024, Vol. 44 ›› Issue (8): 1068-1073.doi: 10.16352/j.issn.1001-6325.2024.08.1068

• 特邀专题:肺动脉高压 • 上一篇    下一篇

门脉高压性肺动脉高压:诊治进展与挑战

付志刚1, 覃佳1, 谭江山2*   

  1. 1.三峡大学第一临床医学院 宜昌市中心人民医院 介入放射科,湖北 宜昌 443003;
    2.中国医学科学院北京协和医学院 国家心血管病中心 阜外医院 国家心血管疾病临床研究中心 肺血管医学重点实验室,北京 100037
  • 收稿日期:2024-06-06 修回日期:2024-06-21 出版日期:2024-08-05 发布日期:2024-07-24
  • 通讯作者: *happyshown@163.com
  • 基金资助:
    宜昌市科技项目(B22-2-003)

Portopulmonary hypertension: advances and challenges in diagnosis and clinical treatment

FU Zhigang1, QIN Jia1, TAN Jiangshan2*   

  1. 1. Department of Interventional Radiology, Yichang Central People′s Hospital, the First College of Clinical Medical Sciences, China Three Gorges University, Yichang 443003;
    2. Key Laboratory of Pulmonary Vascular Medicine, National Clinical Research Center of Cardiovascular Diseases, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
  • Received:2024-06-06 Revised:2024-06-21 Online:2024-08-05 Published:2024-07-24
  • Contact: *happyshown@163.com

摘要: 门脉高压相关性肺动脉高压(PoPH)是门静脉高压患者的并发症之一,死亡率较高,预后差。目前发病机制尚不明确,高动力循环、血管活性物质的失衡、遗传因素以及炎性反应可能共同参与了其病理过程。目前,尚未发现针对PoPH的特异性治疗方法或药物。虽然内皮素受体拮抗剂、前列环素及其类似物、磷酸二酯酶5抑制剂以及鸟苷酸环化酶激活剂等药物已经被用于治疗PoPH患者,但这些药物的疗效和安全性还需通过大规模的临床试验进行验证。肝移植对于部分患者可能带来益处,但也需要综合评估患者的具体情况。本文对PoPH的诊断、流行病学、病理生理学及目前的治疗策略进行了文献梳理,旨在提高对该疾病的认识,促进诊断和治疗水平的提升。未来研究的方向应包括发掘新的治疗药物、评估现有治疗方法的长期效果,以及为PoPH患者提供更为有效和安全的治疗方案。

关键词: 门脉高压相关性肺动脉高压, 诊断, 治疗

Abstract: Portopulmonary hypertension (PoPH) represents one of complications occurred in patients with portal hypertension, which is characterized by high mortality rate and poor prognosis. The pathogenesis of PoPH remains unclear; it is believed to involve a complex interplay of factors including hyperdynamic circulation, imbalance of vasoactive substances, genetic factors and inflammatory responses. Up to the present, there is no specific treatment or medication for PoPH. However, medications such as endothelin receptor antagonists, prostacyclins and their analogues, phosphodiesterase-5 inhibitors and guanylate cyclase stimulants have been applied in the treatment of PoPH patients. The efficacy and safety of these treatment approaches still require further validation through large-scale, multicentered and randomized controlled trials. Liver transplantation may benefit a sub-group of patients but need a comprehensive assessment of individual cases. This article reviews the diagnosis, epidemiology, pathophysiology and current therapeutic performance of PoPH to further understand the pathogenesis of the disease and to improve diagnosis and treatment. Future research should focus on the development of new therapeutic drugs and evaluation of long-term effects of existing treatment methods, thereby providing more effective and safer treatment options to patients with PoPH.

Key words: portopulmonary hypertension, diagnosis, treatment

中图分类号: