心血管
词汇介绍
拓展阅读
解析
Pulmonary 英/'pʌlmən(ə)rɪ/ 美/'pʌlmənɛri/
释 义 adj. 肺的;有肺的;肺状的
同近义词 pneumonic adj. 肺的;有肺的;肺状的
例 句 Results: The cause of congenital pulmonary hypoplasia may be related with heredity and virus infection early on fetus.
结 果 先天性肺发育不全的原因可能与遗传、胚胎早期病毒感染等因素有关。
A rterial 英/ɑː'tɪərɪəl/ 美/ɑr'tɪrɪəl/
释 义 adj. [解剖] 动脉的;干线的;像动脉的
同 根 词 arteriosclerotic n. 动脉硬化的
Objective:To discuss the means and clinic value of transcatheter arterial embolization in traumatogenic hemorrhage.
目的:讨论经导管动脉栓塞治疗创伤性出血的方法和临床价值。
Hypertension 英/haɪpə'tenʃ(ə)n/ 美/,haɪpɚ'tɛnʃən/
释 义 a common disorder in which blood pressure remains abnormally high (a reading of 140/90 mm Hg or greater) n. 高血压;过度紧张
同 根 词 hypertrophy n.[病理] 肥大;过度增大;hypersomnia n.嗜睡,[医] 睡眠过度
例 句 Hypertension and high cholesterol can be controlled.
高血压和高胆固醇可以控制。
概述
定义
肺高压的特征是肺动脉压升高(静息时平均肺动脉压≥25 mmHg)。根据WHO分类系统,肺高压分为5型。肺动脉高压(PAH)用于描述WHO 1型包含的患者,PAH病因包括:特发性和遗传性PAH;药物和毒物;结缔组织病;HIV;门静脉高压;先天性心脏病;血吸虫病。虽然男性和女性均可罹患PAH,但女性更可能受累(女性:男性的比值范围为1.7:1.0-4.8:1.0),女性也更可能出现PAH导致的症状。
临床表现
劳力性胸痛(即,心绞痛)通常是由右心室壁应力和心肌需氧量增加所致的心内膜下灌注不足引起。然而,此症状偶尔是由扩张肺动脉动态压迫冠状动脉左主干引起;肺动脉干直径≥40 mm的患者此风险最高;劳力性晕厥是由于活动时不能增加心输出量,或是缘于右心室中机械性刺激感受器激活所致的反射性心动过缓;外周性水肿是由于右心室衰竭、右侧心脏充盈压升高及血管外容量扩大;厌食和/或右上腹疼痛是由于被动性肝淤血。不常见症状包括咳嗽、咯血和声音嘶哑(Ortner综合征)。声音嘶哑是由扩张的肺动脉主干压迫左喉返神经引起。
诊断标准
诊断PAH需要右心导管术证实静息时mPAP≥25 mmHg以及肺血管阻力>3Wood单位。还必须符合几项额外标准,以排除其他类型的肺高压:平均PCWP<15 mmHg,以排除左心疾病所致肺高压(即,2型肺高压);慢性肺病和其他原因所致低氧血症属轻度或均不存在,以排除由慢性肺病或低氧血症引起的肺高压(即,3型肺高压);不存在静脉血栓栓塞性疾病,以排CTEPH(即,4型肺高压);不存在特定的其他多种疾病,包括全身性疾病(如,结节病)、血液系统疾病(如,骨髓增生性疾病)和代谢性疾病(如,糖原累积病)。目的是排除多因素不明机制的肺高压(5型肺高压)。
治疗
1.一般措施:康复/运动和运动训练、社会心理支持、避孕、疫苗接种。2.支持治疗:抗凝药物、利尿剂、洋地黄、吸氧。3.靶向药物治疗:波生坦;安立生坦;伊洛前列素;曲前列尼尔。4.介入治疗:先天性心脏病相关性肺动脉高压:有适应证的,可进行介入封堵治疗。5.手术治疗:肺动脉血栓内膜剥脱术;肺移植术。
Ironing out pulmonary arterial hypertension复制标题
烫平肺动脉高压
发表时间:2019-06-06
影响指数:9.5
作者: Jodie L. Babitt
期刊:PNAS
The diagnosis is often delayed because the presenting features of PH are frequently attributed incorrectly to age, deconditioning, or a coexisting or alternate medical condition. As a result, PH is often not suspected until symptoms become severe or serious. It has been estimated that more than 20 percent of patients have symptoms of PH for longer than two years before it is recognized. Symptoms — Common symptoms include the following: Dyspnea and fatigue; Symptoms of right ventricular (RV) failure:Exertional chest pain,Exertional syncope,Weight gain from edema,Anorexia and/or abdominal pain and swelling. The diagnosis of PAH requires RHC to demonstrate an mPAP ≥20 mmHg at rest and a pulmonary vascular resistance (PVR) ≥3 Wood units. Several additional criteria to exclude the remaining categories of PH must also be met: Mean pulmonary capillary wedge pressure ≤15 mmHg (to exclude PH due to left heart disease [ie, group 2 PH]);CLDs and other causes of hypoxemia are mild or absent (to exclude PH owing to CLD or hypoxemia [ie, group 3 PH]);Venous thromboembolic disease and pulmonary artery obstructions are absent (to exclude group 4 PH);Certain miscellaneous disorders are absent, including systemic disorders (eg, sarcoidosis, chronic renal insufficiency), hematologic disorders (eg, myeloproliferative diseases and chronic hemolytic anemias), and metabolic disorders (eg, glycogen storage disease). The purpose is to exclude PH with unclear multifactorial mechanisms (group 5 PH).
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