慢性血栓栓塞性肺高血压:第六次世界肺高血压大会新观点

Chronic Thromboembolic Pulmonary Hypertension: Novel Opinion of The 6th World Symposium on Pulmonary Hypertension

2018年2月28日至3月1日在法国尼斯举办了第六次世界肺高血压大会。第十一工作组(Task Force 11)对近5年慢性血栓栓塞性肺高血压(chronic thromboembolic pulmonary hypertension,CTEPH)在定义、分类、病理机制、流行病学、诊断和治疗方面的更新进行了总结,并提出了慢性血栓性疾病的新定义及其与CTEPH的区别。CTEPH的诊疗需要多学科综合评估,随着肺动脉球囊成形术的不断改进,其疗效和安全性明显改善,目前已成为CTEPH的重要治疗方式之一,但其与药物治疗的对比研究尚在进行中,联合治疗疗效仍需长期随访。

The 6th World Symposium on Pulmonary Hypertension was held in Nice between February 28 and March 1,2018. The major progress in chronic thromboembolic pulmonary hypertension( CTEPH) in the past 5 years was reviewed by the experts of Task Force 11. The definition,classification,pathologic mechanisms,epidemiology,diagnosis,and treatment were updated based on available evidence. Chronic thromboembolic disease( CTED) was defined and the difference between CTED and CTEPH was summarized. All CTEPH patients should be evaluated by a multidisciplinary team. Balloon pulmonary angioplasty( BPA),with improved efficacy and safety,plays an important role in CTEPH therapy. An ongoing study investigates patients with CTEPH who are not eligible for pulmonary endarterectomy and are randomized into medicine therapy or balloon pulmonary angioplasty( BPA),and compares the effects of the two therapies. The combination therapy for CTEPH needs the evidence of a long-term follow-up.