Медикаментозное лечение хронической тромбоэмболической легочной гипертензии

Основным методом лечения пациентов с хронической тромбоэмболической легочной гипертензией (ХТЭЛГ) является радикальное хирургическое вмешательство – легочная тромбэндартерэктомия (ЛЭЭ). Однако около 40% больных с ХТЭЛГ неоперабельны в связи с дистальным поражением легочного сосудистого русла или тяжестью гемодинамических нарушений. Почти у 30% пациентов с ХТЭЛГ после хирургического вмешательства отмечается персистирующая или рецидивирующая легочная гипертензия, требующая медикаментозного лечения ЛАГ-специфическими препаратами. В настоящем обзоре приведены актуальные данные по применению таргетной терапии у пациентов с ХТЭЛГ. Обсуждаются место, показания и доказательная база по применению основных групп специфических препаратов, в том числе стимуляторов растворимой гуанилатциклазы, ингибиторов фосфодиэстеразы пятого типа, антагонистов рецепторов эндотелина, аналогов простациклина.

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