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药物治疗对不能手术和在围手术期的慢性栓塞性肺动脉高压患者的治疗起重要的作用。传统的药物如抗凝药物、利尿剂、洋地黄类、氧疗等不能改变疾病的预后,治疗效果也有限。近年来,一些新型药物被用于治疗肺动脉高压,包括前列腺环素类似物、内皮素受体拮抗剂和磷酸二酯酶5的抑制剂等。它们在非栓塞性肺动脉高压的治疗中可以明显改善预后,由于相似的病理机制,所以它们对栓塞性肺动脉高压也可能有效,但证据有限。本文将对这些药物在慢性栓塞性肺动脉高压治疗中的应用作一总结。
Medication plays an important role in the management of inoperable and perioperative patients with chronic embolic pulmonary hypertension. Traditional drugs such as anticoagulants, diuretics, digitalis, oxygen therapy, etc. can not change the prognosis of the disease, the treatment effect is also limited. In recent years, a number of new drugs are used to treat pulmonary hypertension, including prostacyclin analogs, endothelin receptor antagonists and phosphodiesterase 5 inhibitors. They can significantly improve prognosis in the treatment of non-embolic pulmonary hypertension, and because of similar pathological mechanisms, they may also be effective against embolic pulmonary hypertension, with limited evidence. This article will summarize the use of these drugs in the treatment of chronic embolic pulmonary hypertension.