Abstract：The diagnosis and treatment process of a patient with idiopathic pulmonary arterial hypertension who was repeatedly hospitalized in the Department of Respiratory and Critical Care Medicine of West China Hospital of Sichuan University (“our hospital” for short) from October 2013 to June 2016 was retrospectively analyzed, and the treatment and nursing experience of pulmonary arterial hypertension was summarized. The patient was a young female, who had chest tightness after the activity, for more than 3 years, aggravated with syncope and sought treatment in our hospital. The patient was diagnosed as severe pulmonary hypertension by right cardiac catheterization, through cardiac strengthening, diuresis and targeted treatment. After treatment, the patient′s condition improved and was discharged. Because the patient was diagnosed as severe pulmonary arterial hypertension at the first time in our hospital, the best time for treatment has been missed, resulting in repeated aggravation of hospitalization. Pulmonary arterial hypertension as a rare disease, there are relatively few clinical cases, and the medical staff in primary hospitals have a serious lack of understanding of this disease and grasp of the key points of treatment and nursing, leading to missed diagnosis or misdiagnosis of the disease and delayed treatment opportunity. This paper reviews the diagnosis, treatment and nursing progress of pulmonary arterial hypertension through case review and literature review. It is expected to provide reference and guidance for the future clinical treatment of pulmonary arterial hypertension.
冯梅 符小敏 朱晶 陈磊▲. 特发性肺动脉高压患者1例的案例回顾与文献复习[J]. 中国医药导报, 2019, 16(30): 168-171,183.
FENG Mei FU Xiaomin ZHU Jing CHEN Lei▲. Medical record review of 1 case of idiopathic pulmonary arterial hypertension and literature review. 中国医药导报, 2019, 16(30): 168-171,183.
[1] 徐凌，柴晶晶，蔡柏蔷.2009年欧洲呼吸学会和欧洲心脏病学会肺动脉高压指南解读：第一部分[J].国际呼吸杂志，2010，30（8）：449-453.
[2] 段欣，何建国.特发性肺动脉高压的诊治进展[J].中国实用内科杂志，2010，30（12）：1077-1080.
[3] 孙明利，张锐，宁宁，等.基层医院肺动脉高压诊治现状预试验结果分析[J].中国实用内科杂志，2014，34（8）：797-800.
[4] Mereles D，Ehlken N，Kreuscher S，et al. Exercise and respiratory training improve exercise capacity and quality of life in patients with severe chronic pulmonary hypertension [J]. Circulation，2006，114（14）：1482-1489.
[5] 王克芳，张军.妊娠合并肺动脉高压31例妊娠结局分析[J].中国全科医学，2011，14（7C）：2441-2445.
[6] Sliwa K，Van Hagen IM，Budts W，et al. Pulmonary hypertension and pregnancy outcomes: data from the Registry Of Pregnancy and Cardiac Disease（ROPAC）of the European Society of Cardiology [J]. Eur J Heart Fail，2016，18（19）：1119-1128.
[7] 杨涛，何建国.对肺动脉高压患者的管理应有一套完整的策略——2009年欧洲肺动脉高压诊断和治疗指南解读[J].中国循环杂志，2012，11（27）：81-86.
[8] Rich S，Dantzker DR，Ayres SM，et al. Primary pulmonary hypertension：a national prospective study [J]. Ann lntern Med，1987，107（2）：216-223.
[9] Fuster V，Steele PM，Edwards WD，et al. Primary pulmonary hypertension：Natural history and the importance of thrombosis [J]. Circulation，1984，70（4）：580-587.
[10] Jing ZC，Xu XQ，Han ZY，et al. Registry and survival study in chinese patients with idiopathic and familial pulmonary arterial hypertension [J]. Chest，2007，132（2）：373-379.
[11] Galib N，Robin L，Hoeper M，et al. Treatment of patients with mildly symptomatie pulmonary arterial hypertension with bosentan（EARLY study）：a double blind randomized controlled trial [J]. Lancet，2008，371（9630）：2093-2100.
[12] Rossaint R，Lewandowski K，Zapol WM. Our paper 20 years later：Inhaled nitric oxide for the acute respiratory distress syndmme-discovery，current understanding，and focussed targets of future applications [J]. Intensive Care Med，2014，40（11）：1649-1658.
[13] 王岚，李国安，蔡柏蔷.2009年欧洲呼吸学会和欧洲心脏病学会肺动脉高压指南解读：第二部分[J].国际呼吸杂志，2010，8（30）：454-457.
[14] McLaughlin VV. Looking to the future：a new decade of pulmonary aneial hypertension therapy [J]. Eur Respir Rev，2011，20（122）：262-269.
[15] Oischewski H，Simonneau G，Galie N，et al． Inhaled iloprest for revere pulmonary hypertension [J]． N End J Med，2002，347：322-329．
[16] 赵宏林，姚亮，张兴道.曲前列尼尔治疗肺动脉高压临床疗效的系统评价[J].中国循证医学杂志，2016，16（2）： 212-218.
[17] Zhang R，Dai LZ，Xie WP，et al. Survival of Chinese patients with pulmonary arterial hypertension in the modern treatment era [J]. Chest，2011，140（2）：301-309.
[18] 关轶茹，相维，张方.国际肺动脉高压治疗药物偿付政策及对我国的启示[J].中国药学杂志，2015，50（18）：1639-1642.
[19] 周巨彬.前列地尔对慢性肺源性心脏病肺动脉高压疗效的临床研究[J].中国医药科学，2017，7（3）：100-102.
[20] 殷鑫，高卉，张雨，等.门静脉性肺动脉高压1例报告[J].临床肝胆病杂志，2018，34（10）：2203-2205.
[21] 徐军，李志飞，吕一枝，等.西地那非联合高频震荡通气治疗近足月儿持续性肺动脉高压研究[J].中国现代医生，2017，55（16）：54-57，61.
[22] Simonneau G，Gatzoulis MA，Adatia I，et al. Updated clinical classification of pulmonary hypertension [J]. Turk Kardiyol Dern Ars，2014，42 Suppl 1：45-54.
[23] Riedel M，Stanek V，Widimsky J，et al. Longterm follow—up of patients with pulmonary thromboembolism. Late prognosis and evolution of hemody′namic and respiratory data [J]. Chest，1982，81（2）：151-158.
[24] 何建国，郭英华.重视对肺动脉高压新知识的学习和应用[J].中华结核和呼吸杂志，2007，30（9）：649-650.
[25] 刘迎龙，许耀强.加强我国先天性心脏病三级防治[J].中国医药，2017，12（12）：1761-1764.
2019, Vol. 16 
京公网安备 11010502046598号