论文部分内容阅读
目的通过分析围产期心肌病(PPCM)的临床特点,寻找相关危险因素,为临床确立保守治疗方案和分娩时机的选择以减少胎儿死亡提供依据。方法回顾性分析北京协和医院确诊的7例PPCM患者的临床表现、诊断、治疗及预后。结果PPCM是妊娠前后特定时间内出现的以心力衰竭为主要临床表现的疾病,左室射血分数明显减低,为(35.52±9.71)%,其中2例<30%。高龄、多胎、多产、妊娠高血压综合征史为危险因素,死胎发生率较高(3例),急性期除药物治疗外限盐饮食对治疗重要,长期应用β受体阻滞剂及ACE-I可明显改善左室收缩功能(EF提高30%或恢复正常)。结论经及时正规药物治疗PPCM部分患者心脏的结构和功能可以明显改善,胎儿发育成熟应尽早终止妊娠以减少死胎。
Objective To analyze the clinical features of perinatal cardiomyopathy (PPCM) and find out the relevant risk factors so as to provide a basis for establishing a conservative treatment plan and choosing the timing of childbirth in order to reduce fetal death. Methods The clinical manifestations, diagnosis, treatment and prognosis of 7 PPCM patients diagnosed at Peking Union Medical College Hospital were retrospectively analyzed. Results PPCM was a major clinical manifestation of heart failure in a specific time before and after pregnancy. The left ventricular ejection fraction decreased significantly (35.52 ± 9.71%), of which 2 cases <30%. Elderly, multiple births, multiple births, history of pregnancy-induced hypertension are risk factors, and the incidence of stillbirth is high (3 cases). In acute phase, the treatment of external salt diet is important for the treatment of long-term use of β-blockers and ACE- I can significantly improve left ventricular systolic function (EF increased by 30% or returned to normal). Conclusion The structure and function of the heart of patients with PPCM treated by timely formal medication can be obviously improved. Pregnancy should be terminated as soon as possible to reduce stillbirth.