第六届肺动脉高压大会专家意见解读之三——动脉性肺动脉高压危险分层与药物治疗

Interpretation of expert ideas in the 6st World Symposium on Pulmonary Hypertension（Ⅲ）——risk stratification of and drug treatment for pulmonary arterial hypertension

尽管近20年来对动脉性肺动脉高压(PAH)的认识不断深入,也发表了许多随机对照研究,许多新的靶向药物应用于临床,PAH仍然是严重威胁人们健康的一类疾病。研究表明,PAH危险分层有助于判断患者的预后及指导治疗。综合临床、运动、右心功能及血流动力学参数提出的新的危险分层标准,与原有标准对于预后的判断具有较好的一致性,而且临床实用性明显增加。根据危险分层制定合适的初始治疗方案,并在随访中不断评估患者的危险分层,可及时发现可能的恶化并调整治疗方案,改善患者的预后。

Pulmonary arterial hypertension(PAH)remains a severe clinical condition despite the increasing understanding of PAH, the publication of many randomized controlled studies, and the availability of multiple targeted drugs over the past 20 years. Risk stratification of PAH can predict prognosis and guide treatment. The new risk stratification criterion,which combines clinical, exercise, right ventricular function and hemodynamic parameters, has good consistency with the original criteria,and its clinical practicability has increased significantly. Appropriate initial treatment strategies are established based on the risk stratification of newly diagnosed PAH patients. The risk stratification of patients is continuously evaluated during follow-up, and possible deterioration is detected in time. Then the treatment plan can be adjusted to improve the prognosis of patients.