围产期心肌病16例临床分析

目的　分析总结围产期心肌病患者的临床特点及其治疗效果。方法　对 16例围产期心肌病患者进行回顾性总结 ,并结合文献进行讨论。结果　 16例经治疗 ,其中 4例痊愈 ,12例好转 ,有效率 10 0 %。结论　围产期心肌病多发生于产后 1个月内 ,多见于高龄妊娠及多胎生育者 ,治疗主要是控制心衰。做好围产期保健 ,早期发现、及时治疗可减低发病率及改善预后     

20例围产期心肌病的诊治分析

目的分析围产期心肌病的临床特点及其治疗效果。方法回顾性分析20例围产期心肌病患者的临床诊断及治疗资料。结果20例患者经治疗,16例痊愈,3例存在心力衰竭,1例死亡。结论围产期心肌病患者在产后1~2个月内最多见。临床表现以心脏扩大和充血性心力衰竭为主。有1/3合并妊高征,与高龄妊娠有关。加强妇产科医生及孕妇的卫生宣教,早期诊断、早期治疗,预后较好。     

围产期心肌病12例临床分析

目的：分析总结围产期心肌病患者的临床表现及其治疗效果。方法：对12例围产期心肌病患者进行回顾性总结，并结合文献进行讨论。结果：12例患者经治疗，其中4例痊愈，7例好转，有效率为91．7％。结论：围产期心肌病多发生于产后1个月内，多见于围产期保健不好、营养欠佳、贫血、病毒感染及多胎妊娠者，做好围产期保健，早期预防，早期诊断，及时治疗，加强营养，可以减低PPCM的发病率和改善患者的愈后。     

围产期心肌病的预后影响因素

目的 通过研究围产期心肌病的临床特点,为围产期心肌病的诊断和治疗提供参考依据.方法 回顾性分析2008年1月至2019年5月间,在我院诊断为围产期心肌病共34例住院患者的临床资料、检查结果、诊治过程、疾病转归及随访1～114个月的记录.根据复查左室舒张末内径(left ventricular end diastolic...     

20例围产期心肌病的诊治及随访研究

目的:分析总结围产期心肌病的临床特点及其治疗效果。方法:回顾性分析20例围产期心肌病的产科临床和跟踪随访资料。结果:20例患者经治疗15例痊愈,5例死亡。新生儿无1例死亡。结论:围产期心肌病常发生在产后2个月内,临床表现以心脏扩大和充血性心力衰竭为主,多见于高龄妊娠和多胎生育者。治疗主要是控制心衰,首次治疗效果良好者预后较好。     

三磷酸腺苷二钠氯化镁辅助治疗围产期心肌病心力衰竭患者的临床疗效和安全性

<正>围产期心肌病(Peripartum cardiomyopatfy,PPCM)是指既往无心血管病史,于妊娠最后3个月或产后6个月内发生的心肌病。目前,PPCM的病因尚未完全明确,慢性炎症、感染和自身免疫反应可能与其发生相关[1]。严重的围产期心肌病表现为以心肌损害为主的充血性心力衰竭,常常并发各种心律失常及动脉栓塞,致死、致残率高,严重危害母婴健康[2,3]。本研究通过检测三磷酸腺苷二钠氯化镁治疗前后患者左心功能和     

问答

问:何谓围产期心肌病?怎样治疗?答:围产期心肌病(以前称为产后心肌病)也叫分娩前后的心肌病,是孕产妇所特有的于妊娠最后3个月或分娩后5个月内发生的原因不明并以心脏扩大、心律失常和心力衰竭为主要表现的一种心肌病。凡符合下列     

围产期心肌病的诊断与治疗新进展

<正>围产期心肌病(PPCM)是指孕期后3个月至产后6个月出现的原因不明、有典型急性心力衰竭体征的致命性心脏病。围产期心肌病的发病率较低,美国约为1/(3000～4000),国内研究发病率差异较大,该病较凶险,病死率较高,约18%～56%,病死率虽高,如能及早处理,痊愈后心脏可完全恢复正常,多数患者6个月内恢复,再次妊娠会再发生,主要死因为心力衰竭、心律失常和栓塞。     

围产期心肌病的超声诊断

<正> 本文报告我院1995—1999年共11例经临床及超声诊断围产期心肌病,评价超声在围产期心肌病中的诊断价值。 1.资料与方法 本组11例,年龄23—32岁,平均年龄25岁,均为住院患者。发病均在妊娠晚期及产后5个月内。产后发病8例,产前发病3例。     

围产期心肌病

<正> 围产期心肌病属于继发性心肌病的一种类型。临床上把原无器质性心脏病的孕、产妇在妊娠末3个月或产后5个月内,发生原因不明的心力衰竭或扩张型心肌病样改变者,统称为围产期心肌病。本病在国内产妇中的发病率为0.0023％,占妊娠期各种心脏     

Early-onset peri-partum cardiomyopathy in a twin gestation: A rare presentation

Peripartum cardiomyopathy (PPCM) is a rare pregnancy-associated dilated cardiomyopathy occurring in the last month of pregnancy and five months postdelivery, which presents with features of cardiac failure. Diagnosis is based on characteristic echocardiographic findings and elevated cardiac biomarkers and has significant mortality and morbidity when undiagnosed and untreated. Atypical presentations in earlier gestations are rare and associated with risk factors. Here we present a case of PPCM diagnosed in the second trimester in a post in vitro fertilization (IVF) twin pregnancy to emphasize the importance of considering the diagnosis of PPCM in all cases of unexplained cardiac failures during pregnancy in previously healthy patients, especially in the presence of risk factors.     

Peripartum cardiomyopathy searching for a better understanding

Congestive heart failure is an uncommon complication of pregnancy with potentially life-threatening consequences. Peripartum cardiomyopathy (PPCM) is a disease of unknown cause in which severe left ventricular dysfunction occurs during late pregnancy or the early puerperium. In the past, the diagnosis of this entity was made on clinical grounds; however, modern echocardiographic techniques have allowed more accurate diagnoses by excluding cases of diseases that mimic the clinical symptoms and signs of heart failure. Risk factors for peripartum cardiomyopathy include advanced maternal age, multiparity, African descent, twinning, and long-term tocolysis. An extensive search for the causes of peripartum cardiomyopathy has been unrevealing. Treatment does not differ from treatment of idiopathic cardiomyopathy. The prognosis of peripartum cardiomyopathy is related to the recovery of ventricular function. Caution is advised in recommending subsequent pregnancy, especially if left ventricular dysfunction is persistent. In this review, we will discuss different aspects of PPCM as the initial patient contact, obstetricians and family practitioners must recognize this malady early and rapidly institute the proper medical therapy directed towards the congestive state.     

13例围生期心肌病的临床诊治分析

目的：通过对13例围生期心肌病分析,探讨其病因、诊断与治疗及转归。方法回顾性分析13例围生期心肌病的临床资料。结果12患者经积极纠正心衰治疗后均好转。1例患者对治疗反应差,发展为慢性心力衰竭。结论围生期心肌病虽发病率低,但仍有引起严重不良后果的可能,积极治疗可以显著改善预后。     

围生期心肌病患者血清B型脑钠肽与超敏C反应蛋白水平变化及临床意义

目的探讨血清B型脑钠肽（BNP）与超敏C反应蛋白（hs－CRP）水平在围生期心肌病（PPCM）诊断及治疗中的价值。方法测定21例PPCM患者（观察组）BNP、hs－CRP,同时行心脏彩色多普勒超声检测左心室舒张末期内径（LVED）和左心室射血分数（LVEF）,并对患者进行1个月的随访。选取同期住院的正常分娩患者20例作为对照组。结果观察组与对照组比较,BNP[（870．1±168．2）ng／L,（99．2±383）ng／L]、hs-CRP[（28．1±7．2）mg／L,（6。7±2．2）mg／L]明显升高（均P〈001）,hs—CRP与BNP呈正相关（r=0．67,P〈0．01）。经过1个jEj的治疗,观察组平均LVEF由（33．1±9．5）％提高至（5034-12．1）％,BNP、hs－CRP[治疗后分别为（196．6±40．2）ng／L、（7．8±3．1）mg／L]明显下降（均P〈0．01）。结论BNP及hs－CRP可以作为PPCM较好的诊断、治疗参考指标。     

Peripartum cardiomyopathy: current understanding, comprehensive management review and new developments

Peripartum cardiomyopathy (PPCM) is a rare and potentially fatal disease which presents with symptoms of heart failure primarily due to left ventricular (LV) systolic dysfunction in the last month of pregnancy and up to 5-6 months after delivery. PPCM is still regarded as a disease of unknown aetiology, although recent evidence suggests a role for a 16 kDa prolactin derivative produced by proteolytic cleavage of prolactin secondary to unbalanced oxidative stress present during late pregnancy and early puerperium. The medical management of PPCM is similar to other forms of non-ischaemic dilated cardiomyopathy, but with the management tailored to choose safe drugs in pregnancy and lactation to minimise maternal and fetal morbidity. There is an increased risk of venous thromboembolism, and anticoagulation is recommended. About 30-50% of the patients recover without complications, with their baseline LV systolic function at rest returning to normal. The risk of recurrence of PPCM is high, especially if the LV systolic function has not fully recovered. However, for those women who have normal LV systolic function as demonstrated on echocardiography and dobutamine stress test, the risk of severe cardiomyopathy including death is relatively low in a subsequent pregnancy.     

围生期心肌病的病因学研究进展

围生期心肌病是一种特发性、妊娠相关的的心肌病,多发生于妊娠晚期至产后5个月期间,以左室收缩功能减低并引起心力衰竭为主要表现,是导致妊娠妇女死亡的重要原因,发病率有明显升高趋势,目前病因和发病机制尚不清楚。本文较系统地综述了围生期心肌病的病因学研究进展,以期为临床诊治提供帮助。     

Case Report: Acute Limb Ischaemia and Gangrene associated with Peripartum Cardiomyopathy

Thromboembolic complications are frequent in patients with peripartum cardiomyopathy (PPCM). Peripheral artery occlusions are however rare. This case report describes a 30-year-old grand multiparous woman with PPCM complicated by acute lower limb ischaemia and gangrene. This followed left intraventricular thrombi despite maintenance of sinus rhythm. We suspect that the thrombosis is caused by the hypercoagulable state of peripartum period, ventricular dilatation and hypokinesis. The impacts of economic and sociocultural factors in the management of this rare complication of PPCM in a resource depleted nation are highlighted. Keywords: peripartum cardiomyopathy, limb ischaemia.     

围生期心肌病36例临床分析

目的探讨药物治疗围生期心肌病（peripartumcardiomyopathy,PPCM）的方法。方法收集新疆和田市人民医院内科2007年2月-2012年2月36例住院PPCM患者的临床资料,进行回顾性分析。结果36例患者经过强心、利尿和血管扩张剂治疗,适时加用β受体阻滞剂,产后予以ACEI或ARB,全部患者均获治愈,无1例死亡,治疗6个月后X线检查心脏基本恢复正常。结论PPCM的治疗仍以利尿剂、硝酸酯和洋地黄为主,但β受体阻滞剂、ACEI的使用也很重要,远期疗效显著;应用抗凝药物预防血栓治疗值得关注。     

围产期心肌病诊疗分析

目的为了观察围产期心肌病（PPCM）的临床表现及预后,总结救治经验。方法回顾性分析8例确诊为PPCM的患者的临床表现,诊断,治疗及预后。结果 1例因乙肝大三阳,存在严重的肝功能损害,并发败血症,抢救无效死亡。余7例患者均以强心利尿,加强营养等治疗后心衰症状明显改善。复查心脏彩超：8例患者扩大的心腔均较前缩小,2例恢复至正常范围。结论心脏彩超和SPECT对于围产期心肌病的诊断,疗效评价及预后有很重要的价值。强心,利尿剂合用美托洛尔及血管紧张素抑制剂促进了PPCM患者心功能的改善。     

Pregnancy outcomes in women with heart disease

Background As the Shanghai Obstetrical Cardiology Intensive Care Center, our hospital has accumulated a large number of clinical data of pregnant women with heart disease. This paper is a retrospective analysis of 1142 pregnancies in women with heart disease so as to evaluate the maternal and fetal outcomes of these patients.Methods A retrospective analysis was carried out for pregnancies in 1142 women with heart disease who delivered in Shanghai Obstetrical Cardiology Intensive Care Center between 1993 and 2007.Results In this study, main heart diseases in pregnancy were arrhythmia （n=359, 31.4%）, congenital heart disease （CHD; n=291,25.5%）, and myocarditis and its sequelae （n=284, 24.9%）; based on the functional classification criteria of New York Heart Association （NYHA）, more than half （n=678, 59.4%） of patients were classified NYHA Class Ⅰ; pregnant women in NHYA Class Ⅰ-Ⅱ （n=951, 83.3%） commonly had arrhythmia, myocarditis and its sequelae, while those in NHYA Class Ⅲ-Ⅳ （n=191, 16.7%） mainly had CHD, rheumatic heart disease （RHD）, cardiopathy induced by hypertensive disorders complicating pregnancy, and peripartum cardiomyopathy （PPCM）. Cardiac failure occurred in 97 （8.5%）patients, and 8 （0.7%） maternal deaths and 12 （1.1%） perinatal deaths were reported in this study. Compared with those in NHYA Class Ⅰ-Ⅱ, women in NHYA Class Ⅲ-Ⅳ had a significantly lower gestational age at birth （P 〈0.05）, lower birth weight （P 〈0.01）, and higher incidence of preterm delivery, small for gestational age and perinatal death （P 〈0.01）. The incidence of cardiac failure in pregnant women with cardiopathy induced by hypertensive disorders complicating pregnancy and PPCM was relatively high, with a rate of 80% and 52.2%, respectively. After cardiac operation, 131（90.3%） women were in classified NHYA Class Ⅰ-Ⅱ and 14 （9.7%） in NHYA Class Ⅲ-Ⅳ.Conclusions Arrhythmia is the type of heart disease that has a highest incidence in patients with heart disease in pregnancy, while main types of heart disease that impair cardiac function are CHD and RHD; cardiac failure is more frequently caused by cardiopathy induced by hypertensive disorders complicating pregnancy and PPCM; impaired cardiac function increases perinatal morbidity; cardiac surgery before pregnancy could improve the cardiac function.