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慢性阻塞性肺病(简称COPD,包括慢支、哮喘、肺气肿等),是以阻塞性通气功能障碍为主要特征的一类肺部疾患。COPD逐步恶化、潜隐发展,可导致肺动脉高压(PAH),并进而发生右心室肥大,甚至衰竭。因此,消除或阻止PAH的进程对改善COPD患者的预后至关重要。长期以来,PAH一直缺乏有效的治疗方法,最近几年人们从扩血管药物(简称扩管剂)治疗高血压得到启示,开始将其试用于PAH的治疗,使部分病人的预后有所改观。本文就扩管剂在PAH治疗中应用的研究概况作一简要综述。一、扩管剂治疗PAH的主要机制1.舒张肺血管平滑肌、降低肺血管阻力。肺动脉压的高低主要与肺血管阻力、肺血流量及左房压的大小有关,其中缺氧所致的肺血管收缩是COPD患者发生PAH的主要机制。扩管剂通过不
Chronic obstructive pulmonary disease (referred to as COPD, including chronic bronchitis, asthma, emphysema, etc.) is based on obstructive ventilatory dysfunction as a major feature of a class of lung disease. COPD progressive deterioration, latent development, can lead to pulmonary hypertension (PAH), and thus the occurrence of right ventricular hypertrophy, and even failure. Therefore, the process of eliminating or blocking PAH is crucial for improving the prognosis of patients with COPD. For a long time, PAH has been a lack of effective treatment methods. In recent years, people from the vasodilator drugs (referred to as the expander) for the treatment of hypertension have been enlightened, began to try it on the treatment of PAH, so that some patients have some improvement in prognosis. This article gives a brief overview of the research status of the application of the expanding agent in the treatment of PAH. First, the main mechanism of the treatment of PAH expansion of the valve 1. Diastolic pulmonary vascular smooth muscle, reduce pulmonary vascular resistance. The level of pulmonary arterial pressure is mainly related to the pulmonary vascular resistance, pulmonary blood flow and left atrial pressure. The hypoxia-induced pulmonary vasoconstriction is the main mechanism of PAH in COPD patients. Expansion agent is passed