药源性动脉型肺动脉高压的研究进展

孙雪林, 李牧, 胡欣

中国药学杂志 ›› 2019, Vol. 54 ›› Issue (3) : 170-174.

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中国药学杂志
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中国药学杂志 ›› 2019, Vol. 54 ›› Issue (3) : 170-174. DOI: 10.11669/cpj.2019.03.002
综述

药源性动脉型肺动脉高压的研究进展

  • 孙雪林, 李牧, 胡欣*
作者信息 +

Progress on Drug-induced Pulmonary Arterial Hypertension

  • SUN Xue-lin, LI Mu, HU Xin*
Author information +
文章历史 +

摘要

动脉型肺动脉高压(pulmonary arterial hypertension,PAH)是指肺动脉压力升高超过一定界值的血流动力学异常和病理生理状态,表现为肺动脉楔压(pulmonary artery wedge pressure,PAWP)≤15 mmHg,肺血管阻力(pulmonary vascular resistance,PVR)>3 WU。根据病因分类,PAH可能与暴露于某些药物或毒素有关,比如食欲抑制剂、安非他命和选择性5-羟色胺(5-HT)再摄取抑制剂。随着对药源性PAH的认知增加,可识别更多导致PAH的药物。作用机制主要为5-HT水平的升高及受体的激活可以促进肺动脉平滑肌细胞增殖,并导致肺血管的阻塞。药源性PAH属于药物的罕见并发症,可能与个体易感性有关,仍需要进一步研究来确定药物引起的PAH风险。

Abstract

Pulmonary arterial hypertension (PAH) is characterized hemo-dynamically by the presence of pre-capillary pulmonary hypertension, defined by a pulmonary artery wedge pressure (PAWP) ≤15 mmHg and a pulmonary vascular resistance(PVR)>3 wood units (WU). According to the current classification, PAH can be associated with exposure to certain drugs or toxins such as anorectic agents, amphetamines, or selective serotonin reuptake inhibitors. The improvement in awareness and recognition of drug-induced PAH (DIPAH) have allowed the identification of more drugs associated with an increased risk for induction of PAH. The supposed mechanism is the increase of the serotonin level or activation of serotonin receptors that have been demonstrated to promote the growth of pulmonary artery smooth muscle cells and cause progressive obliteration of pulmonary vascular. DIPAH remains a rare complication, which may be associated with individual susceptibility, and further studies are needed to identify patients at risk of DIPAH.

关键词

药源性疾病 / 肺动脉高压 / 不良反应 / 药品

Key words

drug-induced diseases / pulmonary arterial hypertension / adverse effect / drug

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孙雪林, 李牧, 胡欣. 药源性动脉型肺动脉高压的研究进展[J]. 中国药学杂志, 2019, 54(3): 170-174 https://doi.org/10.11669/cpj.2019.03.002
SUN Xue-lin, LI Mu, HU Xin. Progress on Drug-induced Pulmonary Arterial Hypertension[J]. Chinese Pharmaceutical Journal, 2019, 54(3): 170-174 https://doi.org/10.11669/cpj.2019.03.002
中图分类号： R972   

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基金

中央保健局课题资助(W2016ZD01)
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