17例围生期心肌病临床诊疗分析

目的通过分析围生期心肌病（PPCM）的临床表现及预后转归,寻找相关危险因素,总结救治经验。方法回顾性分析17例PPCM患者的临床表现、诊断治疗及预后转归。结果 PPCM临床上主要表现为充血性心力衰竭。左室射血分数显著降低（33.69±9.53）%,左室舒张末期内径明显增大（55.43±5.35）mm。在经过有效治疗6个月后复查心脏彩超发现,左室射血分数显著升高（51.93±10.61）%,左室舒张末期内径均显著缩小（46.84±3.29）mm。吸烟、高龄、多胎多产、妊娠高血压或产前子痫病史为危险因素,强心、利尿合用β受体阻滞剂及ACEI类药物可显著改善患者心功能。结论吸烟和妊娠高血压可能是显著的PPCM发病风险因素。经及时正规药物治疗PPCM部分患者心脏的结构和功能可以显著改善。

Analysis in diagnosis and clinical treatment of peripartum cardiomyopathy

Objective To analyze the clinical symptom and prognosis of peripartum cardiomyopathy（PPCM） in order to discover the risk factors and summarize the therapeutic experience. Methods A retrospective study was performed on seventeen patients admitted to our hospital with a diagnosis of PPCM by analyzing the clinical manifestations diagnosis, treatment and prognosis of patients. Results The major clinical manifestation of PPCM was congestive heart failure. Left ventricular ejection fractions（LVEF） decreased significantly（33.69±9.53）% and left ventricular internal diameters（LVID） in end-diastole obviously increased（55.43±5.35）mm. After successful treatment during acute episode, LVEF increased while LVID decreased obviously. Smoking, multiparity birth, advanced maternal age and pregnancy-induced hypertension or preeclampsia were risk factors. Cardiotonic and dieresis in combination with angiotensin converting enzyme inhibitor（ACEI） can contribute to the improvement in cardiac function of patients. Conclusion Smoking and pregnancy-induced hypertension appear to be significant risk factors. Heart structure and function of some patients can improve obviously with regular drug treatment.