关键词: 围产期心肌病, 预后影响, 左室舒张末内径

Abstract: Objective: To determine predictors and indicators of clinical outcomes of patients with peripartum cardiomyopathy (PPCM).Methods: The retrospective study was conducted from January 2008 to May 2019 at our Hospital. Forty-four cases were collected and followed up for 1-114 months. Recovery was defined as a left ventricular end diastolic diameter (LVEDD) of no more than 50 mm and a left ventricular ejection fraction(LVEF) of no less than 50% . Persistent left ventricular dysfunction was defined as a LVEDD of more than 50mm and LVEF of less than 50% at the end of follow-up.The clinical characteristics, treatment protocols and outcomes of the patients were compared.Results: In this study, the estimated incidence of PPCM was approximately 1/1 710,44 cases were collected and followed up for 1-114 months. 34 of all the patients completed the follow-up.23 (68%) cases recovered and 11(32%) did not. The average age of 23 (68%) was (30.6±7.2) years old. Their body mass index (BMI) was (29.0±2.1)kg/m². The LVEF at diagnosis was (40.02±9.2)%, and the LVEDD was (58.0±6.5)mm. The average age of 11 (32%) was (34.2±5.6) years old. Their body mass index (BMI) was (35.6±1.9)kg/m². The LVEF at diagnosis was (30.9±10.2)%, and the LVEDD was (65.0±6.3)mm. (2) There was no significant difference in the past history, age, onset time, blood pressure, heart rate, hemoglobin, glucose, C reactive protein (CRP), thyroid stimulating hormone(TSH), creatine kinase (CK), creatine kinase isoenzymes (CKMB), NT-proBNP uric acid, pulmonary aterial systolic pressure (PASP) and the percentage of patients taking ACEI or ARB, β-blockers and Digoxin between the two groups (P>0.05). Compared with the control group,the recovery group had lower BMI(t=8.940,P＜0.001),lesser parities(P＜0.001), lesser number of fetus(P＜0.001),higher cardiac troponins(Z=2.024,P=0.043), lesser proteinuria (P=0.002), smaller left ventricular (t=2.965,P=0.006),. higher left ventricular ejection fraction(t=2.633,P=0.012), lesser severity of mitral regurgitation(P＜0.001)and pleural effusions(P＜0.001)and higher bromocriptine(P＜0.001).Conclusion: High body mass index, multiparity, multiple pregnancy, left ventricular end diastolic diameter left ventricular ejection fraction severity of mitral regurgitation and the use of beta blockers or bromocriptine are all indicators of prognosis of patients with PPCM, among which left ventricular end diastolic diameter of being more than or equal to 63mm indicates poor prognosis.

Key words: peripartum cardiomyopathy, prognosis, left ventricular end diastolic diameter