围生期心肌病的临床特征和预后

发布时间：2018-03-25 10:01

本文选题：围生期心肌病　切入点：心力衰竭　出处：《中国医学科学院学报》2016年01期

【摘要】：目的总结围生期心肌病(PPCM)的临床特征及预后。方法回顾性分析北京协和医院1983年1月至2014年12月收治的病例资料较完整的28例PPCM患者的临床资料,随访至少6个月或至全因死亡及心脏移植。结果 28例患者均有不同程度的心功能不全表现,基线左心室射血分数(LVEF)平均为(36.2±11.8)%。21例患者进行了随访,中位随访时间27个月,16例(76%)LVEF改善;5例(24%)患者无改善,其中1例死亡。改善组和无改善组患者在基线LVEF(P=0.007)、基线左心室舒张末期内径(LVEDD)(P=0.040)、随访时LVEF(P0.001)和随访时LVEDD(P0.001)方面差异均有统计学意义。Cox回归分析结果显示,基线LVEF高(RR:0.89,95%CI:0.83~0.96,P=0.002)和LVEDD小(RR:0.90,95%CI:0.83~0.99,P=0.026)与PPCM患者LVEF改善相关。结论 PPCM经及时诊断和正规治疗,部分患者的心功能可明显改善,基线LVEF高或LVEDD小的患者左心室收缩功能恢复的可能性大。
[Abstract]:Objective to summarize the clinical features and prognosis of perinatal cardiomyopathy (PPCM). Methods the clinical data of 28 patients with PPCM admitted from January 1983 to December 2014 in Peking Union Hospital were retrospectively analyzed. All patients were followed up for at least 6 months. Results all 28 patients had different degree of cardiac insufficiency. The mean left ventricular ejection fraction (LVEF) was 36.2 卤11.80.21 patients were followed up. The median follow-up time was 27 months. No improvement was found in 16 patients with LVEF. One of them died. There were significant differences between the two groups in baseline LVEFG P0. 007, baseline left ventricular end-diastolic diameter (LVEDD-P0. 040), follow-up LVEFV P0. 001) and follow-up LVEDDP 0. 001). Cox regression analysis showed that there were significant differences between the two groups. The baseline LVEF high RR: 0.89 / 95 CI: 0.83 0. 96% P0. 002) and LVEDD small R: 0. 90 0. 90 + 95: 0. 09 P0. 026) are related to the improvement of LVEF in PPCM patients. Conclusion after timely diagnosis and regular treatment of PPCM, the cardiac function of some patients can be significantly improved, and the recovery of left ventricular systolic function in patients with high baseline LVEF or small LVEDD is more likely.
【作者单位】：中国医学科学院北京协和医学院北京协和医院内科;中国医学科学院北京协和医学院北京协和医院心内科;
【分类号】：R714.7

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