中国肺动脉高压诊治临床路径

中国循环杂志2023年7月第38卷第7期（总第301期）Chinese Circulation Journal.July.2023.Val.38No.7(Serial No.301)691指南与共识中国肺动脉高压诊治临床路径国家心血管病中心肺动脉高压专科联盟国家心血管病专家委员会右心与肺血管病专业委员会摘要肺动脉高压是一种常见的血液动力学异常状态，涉及多学科、多系统，诊疗难度大，致死率、致残率高，严重威胁我国居民的生命健康。目前，我国基层医疗机构在肺动脉高压的管理中仍存在医疗技术力量不足、综合管理意识薄弱、诊疗规范性欠缺和啭诊机制不完善等问题。为适应日益增长的医疗需求，国家心血管病中心肺动脉高压专科联盟、国家心血管病专家委员会右心与肺血管病专业委员会基于当前的循证医学证据和基层诊疗实践，制定了《中国肺动脉高压诊治临床路径》。本文针对肺动脉高压的诊断流程、风险分层、治疗策略、转诊和随访等提出了详细的推荐意见，旨在为基层医务人员提供肺动脉高压诊治管理的全面指导，以提高基层诊疗水平，规范基层诊疗行为。关键词肺动脉高压；右心导管：基层诊疗；临床路径Chinese Clinical Pathway for Diagnosis and Treatment of Pulmonary HypertensionChina Specialty Alliance for Pulmonary Hypertension,National Center for Cardiovascular Diseases,National Committee of RightHeart and Pulmonary Vascular Diseases of National Expert Commission for Cardiovascular DiseasesCorresponding Author:LIU Zhihong.Email:zhihongliufuwai@163.comAbstractPulmonary hypertension (PH)is a common hemodynamic abnormality involving multiple disciplines and systems,withhigh morbidity and mortality rates,posing a serious threat to the life and health of Chinese residents.Currently,there are stillproblems such as insufficient medical technical resources,weak comprehensive management awareness,lack of diagnosticand treatment standards,and imperfect referral mechanisms in the management of PH in primary medical institutions in China.In order to adapt to the growing medical demand,China Specialty Alliance for Pulmonary Hypertension,National Centerfor Cardiovascular Diseases,National Committee of Right Heart and Pulmonary Vascular Diseases of the National ExpertCommission for Cardiovascular Diseases jointly developed the "Chinese Clinical Pathway for Diagnosis and Treatment ofPulmonary Hypertension"based on current evidence-based medicine and primary care practices.This clinical pathway aims toprovide detailed recommendations for the diagnosis algorism,risk stratification,treatment strategies,referral,and follow-up ofPH,in an effort to give comprehensive guidance for primary healthcare professionals in the management of PH,improve the levelof primary care,and standardize the behavior of primary care practices on PH.Key words:pulmonary hypertension;right heart catheterization;primary care;clinical pathwayFunding:National High Level Hospital Clinical Research Funding(2022-GSP-GG-35)(Chinese Circulation Journal,2023,38:691.)肺动脉高压(pulmonary hypertension,.PH)是以以上的人群中PH患病率可高达10%，PH已成为肺动脉压力升高为特征的一种异常的血液动力学状严重威胁人类的全球性健康问题。《2022年中国心态和病理生理综合征)，其致死率、致残率高。当血管病医疗质量报告》显示，我国PH的知晓率、诊前数据表明，全球约1%的成年人患有PH,65岁断率和治疗率均不理想，特别是在基层医疗机构中，基金项目：中央高水平医院临床科研业务费资助项目(2022-GSP-GG-35】通信作者：柳志红Eml:小hongliufuwai@163.com中图分类号：R54文款标识码：C文章编号：1000-3614(2023)07-0691-13D0L103969.ikn.1000-3614.2023.07.002