基于神经激素系统治疗肺动脉高压进展

Progress on Treatment of Pulmonary Hypertension Based on Neurohormonal System

肺动脉高压(pulmonary hypertension,PH)是一种进行性进展的致死性心肺疾病,最终会导致右心衰竭和死亡,其发病率和死亡率逐年上升。目前PH的发病机制尚不明确,且缺乏有效的治疗手段。最近的研究表明,在PH患者及动物模型中存在自主神经系统(autonomic nervous system,ANS)失衡和肾素-血管紧张素-醛固酮系统(renin-angiotensinaldosterone system,RAAS)激活的现象,参与促进PH发生发展,并且与PH患者预后紧密相关。综述了针对神经激素系统的干预方法对PH的作用及相应机制,包括α/β受体阻滞剂、β3受体激动剂、肺动脉去神经、肾去神经、交感神经节阻滞、迷走神经刺激及RAAS抑制剂,以期为PH治疗提供新的手段。

Pulmonary hypertension(PH)is a progressive,fatal cardiopulmonary disease,and eventually leads to death due to right heart failure.The pathogenesis of PH has not been clarified and there is a lack of effective treatment for PH.Recent studies have shown that autonomic nervous system(ANS)imbalance and renin-angiotensin-aldosterone system(RAAS)activation are found in PH patients and animal models,which are involved in promoting the occurrence and development of PH and are closely related to the prognosis of PH patients.This paper reviewed the effects and mechanisms of intervention methods targeting the neurohormonal system,includingα/βblockers,β3 agonists,pulmonary artery denervation,renal denervation,sympathetic ganglion block,vagus nerve stimulation and RAAS inhibitors on PH,in order to provide a new method for the PH treatment.