慢性血栓栓塞性肺疾病与慢性血栓栓塞性肺动脉高压:新概念与新思路

Chronic thromboembolic pulmonary disease and chronic thromboembolic pulmonary hypertension:the new concept and consideration

慢性血栓栓塞性肺疾病(CTEPD)是急性肺血栓栓塞症(PTE)的一种远期并发症。由于慢性血栓持续存在于肺动脉管腔内,并逐渐机化及纤维化,肺动脉近端血管发生阻塞性病变,远端血管继发微血管病变,肺血管阻力进行性增加,部分患者可出现肺动脉高压,并进展为右心衰竭。CTEPD起病隐匿,临床常表现为呼吸困难,可伴有低氧血症,严重影响患者的生活质量。因此,对于这类患者,需强调终身抗凝治疗和定期随访评估。

Chronic thromboembolic pulmonary disease(CTEPD) is a long-term complication of acute pulmonary thromboembolism(PTE). Due to the persistence of chronic thrombi in the pulmonary artery and its progressive organization and fibrosis,the proximal vessels of the pulmonary artery present obstructive lesions,and the distal vessels present secondary microvasculopathy. Consequently,pulmonary vascular resistance may increase,and some patients may develop pulmonary hypertension and progress to right heart dysfunction. CTEPD develops insidiously and usually presents with dyspnea and be complicated with hypoxemia,which severely affects patients’ quality of life. Therefore,lifelong anticoagulation therapy and regular follow-up procedure are of great significance.