慢性阻塞性肺疾病并发肺动脉高压的研究进展

Research progress of chronic obstructive pulmonary disease complicated with pulmonary hypertension

肺动脉高压(PH)是慢性阻塞性肺疾病(COPD)常见的并发症之一,PH具有进展性,贯穿于COPD的进展过程,可导致运动能力下降、右心衰竭。COPD患者肺血管系统中的一系列生物学、结构和功能变化共同引起PH,包括低氧、炎症、内皮细胞功能紊乱及肺血管重构,最终导致慢性肺源性心脏病。迄今为止尚缺乏COPD并发PH(PH-COPD)治疗的理想药物,关于其特异性血管扩张药物现缺乏大规模研究,对小规模研究存在较大争议,由此给临床工作带来了一定的困难。本文就该疾病的发病机制及特异性血管扩张剂治疗进行综述。

Pulmonary hypertension (PH) is one of the common complications of chronic obstructive pulmonary disease (COPD). PH is progressive and can run through the progress of COPD, and it can lead to the decline of exercise ability and the right heart failure. In the pulmonary vascular system of COPD patients, a series of biological, structural and functional changes can jointly cause PH, including hypoxia, inflammation, endothelial cell dysfunction and pulmonary vascular remodeling, and finally, it leads to chronic pulmonary heart disease. So far, there is still a lack of ideal drugs for the treatment of COPD and PH (PH-COPD). There is currently no large-scale research in terms of its specific vasodilator. There is much controversy in terms of small-scale research. Therefore, it brings certain difficulties to clinical work. In this article, the pathogenesis of the disease and the treatment with specific vasodilators are summarized as follows.