围生期心肌病的病因、诊断与治疗  

The Etiology,Diagnosis and Treatment of Peripartum Cardiomyopathy

作　　者：徐欣然[1] 崔洪艳[1] 

机构地区：[1]天津市中心妇产科医院,300100

出　　处：《国际妇产科学杂志》2014年第6期650-654,共5页Journal of International Obstetrics and Gynecology

摘　　要：围生期心肌病是指在妊娠晚期或分娩后5个月发生的特发性心肌病,临床表现为由于左心室收缩功能障碍引起心力衰竭,该病发生于既往健康的妇女,病因尚不明确。该病的发生率低,死亡率却很高,预后也有很大差异。临床症状主要有呼吸困难、咳嗽、颈静脉扩张、水肿等心力衰竭表现,个别患者可能发生心律失常甚至心肌梗死。诊断主要依靠超声心动图、心脏磁共振检查等。对该病可应用强心、利尿及抗凝药物治疗。有些患者的临床症状和超声心动图表现为迅速改善并恢复正常;而有些患者临床症状迅速恶化,药物治疗根本无效,由持续性左心室功能障碍发展为慢性心力衰竭,可以考虑使用机械性心室辅助装置及心脏移植等方法。综述该病在病因研究、诊断、治疗及预后方面的进展情况。Peripartum cardiomyopathy is defined as an idiopathic cardiomyopathy manifested as heart failure due to left ventricular systolic dysfunction toward the end of pregnancy or in five months after delivery when no other causes of heart failure ars found. Peripartum cardiomyopathy occurs in previously healthy woman,with unknown origin. Although the incidence is low, the mortality rate is high,and the prognosis is different. The patients commonly have dyspnea,cough,neck vein distension and edema,some patients even occurred arrhythmia and myocardial infarction. Diagnosis relies mainly on echocardiography and magnetic resonance images. The disease can be treated by positive myodynamia ,diuresis,and anticoagulant drugs. In some patients the clinical symptoms and ultrasonic cardiogram quickly improve and return normal;but in other patients,the clinical symptoms rapidly deteriorating and the drug treatment is ineffective ,if persistent left ventricular dysfunction develop to chronic heart failure,ventricular assist devices and cardiac transplantation maybe required. Summarize the etiology ,diagnosis and treatment management of the disease.

关 键 词：产褥期疾病 心肌疾病 妊娠 心力衰竭 

分 类 号：R714.7[医药卫生—妇产科学]