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围生期心肌病:亚洲一家三级医疗中心的经验。

Peripartum cardiomyopathy: experience in an Asian tertiary centre.

机构信息

National Heart Centre Singapore, Singapore.

出版信息

Singapore Med J. 2013 Jan;54(1):24-7. doi: 10.11622/smedj.2013006.

Abstract

INTRODUCTION

Peripartum cardiomyopathy (PPCM) is a rare but life-threatening condition. We report 11 patients admitted to the National Heart Centre Singapore with a diagnosis of PPCM over a period of 14 months.

METHODS

Baseline demographics, pregnancy history, haematology, serum biochemistry and echocardiographic findings of women admitted with a diagnosis of PPCM were analysed.

RESULTS

The incidence of PPCM was 0.89 per 1,000 live births in our cohort. 63.6% of the patients were Malay and 27.3% were Chinese. 45.5% of the patients were smokers and 45.5% had a history of pregnancy-induced hypertension or preeclampsia. There was no maternal mortality. Mean left ventricular ejection fractions at diagnosis and at six months were 26.9% ± 9.1% and 51.9% ± 10.6%, respectively. Mean left ventricular internal diameters in end-diastole at diagnosis and at six months were 5.5 ± 0.5 cm and 5.1 ± 0.6 cm, respectively. All patients were treated successfully for the acute episode and all but one patient had returned to New York Heart Association functional class I status at six months.

CONCLUSION

PPCM remains a rare condition and appears to occur more commonly in Malay patients. Smoking and pregnancy-induced hypertension appear to be significant risk factors. While short-term outcome remains excellent, collaborative studies with other tertiary centres will help enhance our understanding of the long-term management of and clinical outcomes in these patients.

摘要

简介

围产期心肌病(PPCM)是一种罕见但危及生命的疾病。我们报告了在 14 个月的时间里,有 11 名患者因 PPCM 被收入新加坡国家心脏中心。

方法

分析了诊断为 PPCM 的女性的基线人口统计学、妊娠史、血液学、血清生化和超声心动图检查结果。

结果

在我们的队列中,PPCM 的发病率为每 1000 例活产 0.89 例。63.6%的患者为马来人,27.3%为华人。45.5%的患者为吸烟者,45.5%有妊娠高血压或先兆子痫病史。没有产妇死亡。诊断时和 6 个月时的平均左心室射血分数分别为 26.9%±9.1%和 51.9%±10.6%。诊断时和 6 个月时的平均左心室舒张末期内径分别为 5.5±0.5cm 和 5.1±0.6cm。所有患者的急性发作均成功治疗,除 1 例患者外,所有患者在 6 个月时均恢复到纽约心脏协会功能Ⅰ级。

结论

PPCM 仍然是一种罕见的疾病,似乎在马来患者中更为常见。吸烟和妊娠高血压似乎是重要的危险因素。虽然短期预后仍然良好,但与其他三级中心的合作研究将有助于提高我们对这些患者的长期管理和临床结局的理解。

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