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肺動脈高壓患者之藥物吸入治療

Inhaled Drug Therapy for Patients with Pulmonary Arterial Hypertension

摘要


肺動脈高壓是一種進行性的肺血管疾病,主要特徵為肺血管增生及血管痙攣造成平均肺動脈壓與肺動脈血管阻力持續上升,臨床主要表現為虛弱、胸痛、呼吸急促、呼吸困難、與漸進性血氧不足,末期將導致右心室肥大而衰竭使病人死亡。近年來對於這個疾病有更深入的瞭解,加上分子生物與藥物研發技術進步,針對肺動脈高壓的治療,藥物陸續問世,特別在吸入性藥物治療也有許多臨床研究發表,呼吸治療師治療肺動脈高壓時除了給予一氧化氮吸入治療外,也將給與吸入性藥物與新式噴霧器,本文將利用文獻回顧的方式,深入探討肺動脈高壓的吸入型藥物及特殊噴霧器的應用原理,以增進呼吸治療臨床照護技能。

並列摘要


Pulmonary arterial hypertension (PAH) is a progressive pulmonary vascular disease, characterized by pulmonary vascular proliferation and vasoconstriction. As result, the pulmonary arterial pressure and vascular resistance increased gradually. Clinical symptoms of PAH include weakness, chest pain, short of breath, dyspnea, hypoxemia, right heart failure, and death eventually.The new medications for PAH including inhaled ones have been introduced due to the understanding of disease and the advance of molecular biology on drug development. Inhaled drug therapy has been studies under several clinical trails for treatment of PAH. In addition to inhaled nitric oxide treatment, respiratory therapist will provide aerosol therapy with inhaled vasodilation agents and new devices in the near future. The purpose of this review article was to discuss the pathology and remedy of PAH, and most important to introduce the approved new inhaled agents and their accompanied devices.

參考文獻


Badesch DB, Raskob GE, Elliott CG, et al. Pulmonary arterial hypertension: baseline characteristics from the REVEAL registry. Chest 2010;137:376-387.
Humbert M, Lynch J. Pulmonary Hypertension. Vol. 236. New York, NY: Informa Healthcare USA, Inc; 2009.
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McLaughlin V, Humbert M, Coghlan G, et al. Pulmonary arterial hypertension: the most devastating vascular complication of systemic sclerosis. Rheumatology 2009;48 Suppl 3: iii25–31.

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