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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。
Objective To analyze the clinical manifestations and prognosis of perinatal cardiomyopathy (PPCM), find the relevant risk factors, and summarize the experience of treatment. Methods Retrospective analysis of 17 cases of PPCM patients with clinical manifestations, diagnosis and treatment and prognosis prognosis. Results The main clinical manifestations of PPCM congestive heart failure. Left ventricular ejection fraction decreased significantly (33.69 ± 9.53)%, left ventricular end diastolic diameter increased significantly (55.43 ± 5.35) mm. After effective therapy for 6 months, retrospective study showed that left ventricular ejection fraction was significantly increased (51.93 ± 10.61)%, and left ventricular end-diastolic diameter was significantly reduced (46.84 ± 3.29) mm. Smoking, elderly, multiple births, pregnancy-induced hypertension or pre-eclampsia were risk factors. Cardiac function was significantly improved in patients with cardiotonic and diuretic combined with β-blockers and ACEIs. Conclusion Smoking and pregnancy-induced hypertension may be significant risk factors for PPCM. The structure and function of the heart of some patients with PPCM can be significantly improved by timely formal drug treatment.