Guangzhou Daily News (all media reporter Weng Shuxian correspondent Han Wenqing) May 5th is the "World Pulmonary Hypertension Day". At the relevant science lectures held in the Datansha Campus of the First Affiliated Hospital of Guangzhou Medical University, the First Affiliated Hospital of Guangzhou Medical University, the respiratory Zhong Nanshan, a leading figure in the discipline and academician of the Chinese Academy of Engineering, has repeatedly reminded that the most important thing in dealing with pulmonary hypertension is early diagnosis and early treatment.
Professor Liu Chunli, an expert from the Nanshan Famous Medical Group of the First Hospital of Guangzhou Medical University, suggested that people with a family history of pulmonary arterial hypertension or high-risk factors such as congenital heart disease, rheumatic connective tissue disease, liver cirrhosis, portal hypertension or severe chronic lung disease should be actively screened regularly to avoid Only passively do inspections after problems occur, so as not to miss the opportunity for early diagnosis and treatment.
Pulmonary arterial hypertension is easily misdiagnosed
"When it comes to pulmonary arterial hypertension, everyone may be unfamiliar." Zhong Nanshan pointed out that it can be caused by the disease of the pulmonary blood vessel itself, or it can be secondary to the impact of heart disease on the pulmonary circulation, and it may also be caused by chronic obstructive pulmonary disease and pulmonary embolism.
Because of this, many patients didn't realize it after they got sick before, and some grassroots doctors didn't know much, so it was easy to misdiagnose.
"Pulmonary arterial hypertension, as the name implies, is an increase in the pressure inside the pulmonary artery. It used to be called pulmonary arterial hypertension." Professor Liu Chunli, an expert from the Nanshan Famous Medical Group of the First Hospital of Guangzhou Medical University, explained that this disease is caused by various reasons. The increased pressure increases the burden on the right ventricle, and the right ventricular hypertrophy and insufficiency of the right ventricular function gradually occurs. If the treatment is not timely intervened, shortness of breath, hypoxia and even syncope after exercise will eventually occur. In severe cases, heart failure and death may occur. .
According to Liu Chunli, there are about 50 million patients with pulmonary arterial hypertension worldwide. In recent years, the prevalence of people over the age of 65 has increased to 5%-10%.
There are more than 200 causes of pulmonary hypertension, of which idiopathic and familial pulmonary hypertension are rare diseases.
Such patients take an average of 2 to 3 years and see 3 to 5 doctors to be diagnosed.
Regular screening is recommended for high-risk groups
Zhong Nanshan emphasized that the most important thing in dealing with pulmonary hypertension is early diagnosis.
In the past, because the diagnosis was too late, some patients were diagnosed at an advanced stage, the 5-year survival rate was not high, and the quality of life was not very good.
How can we detect and diagnose early?
Liu Chunli reminded that people with the following high-risk factors of pulmonary arterial hypertension are recommended to take regular active screening to avoid passive examinations after problems occur, so as not to miss the opportunity for early diagnosis and treatment:
1. Have a family history of pulmonary hypertension;
2. Patients with connective tissue diseases, such as patients with systemic scleroderma and systemic lupus erythematosus;
3. Congenital heart disease;
4. Portal hypertension of liver cirrhosis;
5. There is a history of using weight loss drugs;
6. Severe chronic lung disease (chronic obstructive pulmonary disease, interstitial lung disease, bronchiectasis, sleep apnea syndrome);
7. Chronic pulmonary embolism or recurrent pulmonary embolism.
How can I diagnose the presence of pulmonary hypertension?
Liu Chunli said that there are two commonly used screening methods: one is echocardiography, which can indirectly estimate pulmonary artery pressure; the other is right heart catheterization, which directly measures pulmonary artery pressure.
If pulmonary hypertension is suspected, echocardiography can be done first. If pulmonary hypertension is highly suspected, right heart catheterization should be done. It can accurately measure pulmonary arterial pressure to help diagnose.
Pulmonary arterial hypertension is not a "terminal illness"
Is pulmonary arterial hypertension scary?
"As Academician Zhong said, in the past it was scary because it was diagnosed at an advanced stage and the mortality rate was high." Liu Chunli said frankly.
However, if early diagnosis and standardized treatment can be made, pulmonary arterial hypertension is not a "terminal illness".
The reason why this disease makes people feel "terrifying" is that before the advent of targeted drugs, the 5-year survival rate of patients with idiopathic pulmonary arterial hypertension in the world is basically only more than 20%, "that is to say, after diagnosis, Only 2.8 years to live." But with the advent of more drugs, the five-year survival of patients has improved significantly.
She cited a study on the long-term survival of patients with pulmonary arterial hypertension in Japan and pointed out that as long as early detection, early diagnosis and standardized treatment, there will be no deaths after 10 years among the patients enrolled in this study. Hypertension is no longer a terminal illness.”
According to Zhong Nanshan, the use of combined therapy can greatly improve the quality of life of patients with pulmonary arterial hypertension, and they can even work, study and live like normal people. "Of course, strenuous exercise is not enough." Only very few patients need lung transplantation.
"We don't want to go that far. We hope that there will be a good way to treat it when it is discovered at an early stage. The earlier it is discovered, the better the effect of treatment."
Liu Chunli added that patients with pulmonary arterial hypertension must receive standardized diagnosis and treatment as soon as possible. At present, there are nearly 10 kinds of drugs for the treatment of pulmonary arterial hypertension in China, and some of them have been included in medical insurance.