37例围产期心肌病临床分析

发布时间：2018-12-15 14:45

【摘要】：目的：通过对我院围产期心肌病病例资料统计，总结该病的发病特点、临床特征及预后，提高对围产期心肌病的认识。方法：搜集2008年11月-2013年11月于吉林大学第二医院住院的37例围产期心肌病病历资料，采用回顾性分析的方法，分析其一般临床资料、症状和体征、相关辅助检查（如:心电图、心脏彩超、实验室检查等）、诊治及预后等。结果：1.本组患者初产妇21例（56.7%），经产妇16例（43.3%）.农村患者26例(70.2%)，，城镇患者11例(29.8%)。 2.围产期心肌病主要临床表现为劳累性胸闷、气短（28/37）、夜间阵发性呼吸困难（20/37）、心悸(18/37).且入院患者心功能绝大部分为III-IV级（34/37），心功能II级仅3例。 3.围产期心肌病患者低蛋白血症发病率较高（14/37），且D-二聚体升高明显，监测D-二聚体18例，其中14例1000μg/L 4.本组患者37例，死亡4例（10.8%），复查心脏彩超17例，EF恢复正常12例。结论：1.本组围产期心肌病初产妇发病率相对较高（56.7%）与国外流行病学结果不符。 2．劳累性胸闷、气短、心悸及夜间阵发性呼吸困难为围产期心肌病的常见症状，围产期女性出现上述症状应考虑围产期心肌病，提高早期诊断，降低漏诊率。 3．围产期心肌病患者易出现低蛋白血症及栓塞。 4.围产期心肌病发病率虽然较低，但死亡率较高（本组患者死亡率10.8%），经系统内科治疗后，其预后较好，应提高早期诊断及治疗，降低死亡率。
[Abstract]:Objective: to summarize the characteristics, clinical features and prognosis of perinatal cardiomyopathy in our hospital, and to improve the understanding of perinatal cardiomyopathy. Methods: 37 cases of perinatal cardiomyopathy hospitalized in the second Hospital of Jilin University from November 2008 to November 2013 were collected. The general clinical data, symptoms and signs were analyzed by retrospective analysis. Related auxiliary examination (e. G. Electrocardiogram, echocardiography, laboratory examination, etc.), diagnosis, treatment and prognosis. Results: 1. 21 cases (56.7%) were primipara, 16 cases (43.3%) were menopausal. There were 26 cases (70.2%) in rural areas and 11 cases (29.8%) in towns. 2. The main clinical manifestations of perinatal cardiomyopathy are tiring chest tightness, shortness of breath (28 / 37), nocturnal paroxysmal dyspnea (20 / 37), palpitation (18 / 37). Cardiac function was mostly III-IV grade (34 / 37) and cardiac function II grade was only 3 cases. 3. The incidence of hypoproteinemia in perinatal cardiomyopathy patients was high (14 / 37), and the level of D- dimer was significantly increased. 18 cases of D- dimer were monitored, of which 14 cases were 1000 渭 g / L ~ (4). Of the 37 patients, 4 died (10.8%), 17 were examined by echocardiography, 12 EF returned to normal. Conclusion: 1. The incidence of perinatal cardiomyopathy was relatively high (56.7%). 2. Tired chest tightness, shortness of breath, palpitation and nocturnal paroxysmal dyspnea are common symptoms of perinatal cardiomyopathy. Perinatal women should consider perinatal cardiomyopathy to improve early diagnosis and reduce the rate of missed diagnosis. 3. Perinatal cardiomyopathy patients are prone to hypoproteinemia and embolism. 4. Although the incidence of perinatal cardiomyopathy is low, the mortality rate is higher (mortality rate is 10.8%). After systemic medical treatment, its prognosis is better, so the early diagnosis and treatment should be improved and the mortality rate should be reduced.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R714.7

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