围产期心肌病患者的预后探讨

丁晓曼 杨剑秋 2005-12-13 13:06:57 中华实用医药杂志 2004年8月第4卷第15期

　　【摘要】 目的 总结我院围产期心肌病患者的预后。方法 回顾性分析北京协和医院自1992年1月1日～2001年12月31日收治的围产期心肌病患者。结果 采用Hibbard等提出的诊断标准，有6例患者被确诊为围产期心肌病。左心室的射血分数平均为36.8%±9%。其中66.7%的初产妇，并且33.3%合并妊娠高血压综合征。治疗包括利尿、减少后负荷，增强心肌收缩力以及抗凝治疗。除1例患者剖宫产术中死于肺栓塞外，其余患者预后良好，没有严重的并发症。结论 本研究中围产期心肌病患者的预后不同于既往的文献报道，尤其是初产妇的预后较好。其原因可能是患者的年龄轻，并且合并其他慢性疾病的机率低。

　　关键词 围产期心肌病预后

　　Prognosis of peripartum cardiomyopathy

　　Ding Xiaoman，Yang Jianqiu.

　　Department of Obstetric Gynecology，Peking Union Medical College Hospital，

　　Peking Union Medical College， Chinese Academy of Medical Science，Beijing100730.

　　【Abstract】 Objective To investigate the prognosis of patients with peripartum cardiomyopathy in our hospiˉtal.Methods The cases of peripartum cardiomyopathy treated at Peking Union Medical College Hospital in China，from January1，1992，to December31，2002，were reviewed.Results Based on Hibbards’diagnostic criteria for the disease，six patients with peripartum cardiomyopathy were identified.The mean ejection fraction was36.8±9%.Of them，66.7%of patients were nulliparous，and the prevalence of pregnancy-induced hypertension was33.3%.Medical management consisted of diuresis，afterload reduction，inotropic support，and anticoagulation.Except one patient died of pulmonary embolism during cesarean operation，no other major complications were observed.Conclusion The prognosis of patient with peripartum cardiomyopathy in this study differed from those in published reports，probably because of the low frequency of coexisting chronic disease and a younger age at diagnosis.