摘要
目的 探讨围生期心肌病（PPCM）发病的相关因素.方法 时82例PPCM患者进行流行病学调查,检查心脏彩超,测定肌钙蛋白I（cTNI）、高敏C-反应蛋白（hs-CRP）、N末端B型利钠肽（NT-proBNP）等指标,并随机对其中52例患者进行了平均6个月的随访.对照组选用同期住院的正常分娩患者.结果 PPCM患者与对照组相比,年龄较大[分别为（29.5±6.4）岁和（25.2±5.8）岁,P〈0.01],血压较高（分别为146.9/98.8 mm Hg和130.2/80.1 mm Hg,P〈0.01）,剖宫产比例较高（分别为65.9%和51.0%,P〈0.05）,合并感染率明显升高（分别为75.6%和10.0%,P〈0.01）,实验室检查白细胞（分别为11.0×109/L和8.8×109/L,P〈0.01）、cTNI（分男q为0.17μg/L和0.06μg/L,P〈0.01）、hs-CRP（分别为2 8.2ms/L和6.2 mg/L,P〈0.01）、NT-proBNP（分别为650.1 ng/L和110.5 ns/L,P〈0.01）明显升高,hs-CRP和NT-proBNP呈正相关（r=0.67,P〈0.01）.经过平均6个月的治疗,平均射血分数由32.2%提高至50.6%,NT-proBNP明显下降（治疗前、后分别为650.1 ng/L和225.6 ng/L,P〈0.01）,NT-proBNP下降的独立影响因素为舒张压下降（P〈0.05）、左心室舒张末径缩小（P〈0.05）和hs-CRP下降（P〈0.05）.结论 炎症反应在围生期心肌病发病中起了重要的作用.
Objective To explore the risk factors of peripartum cardiomyopathy （PPCM）. Methods A total of 82 PPCM and 100 normal delivery females were randomly recruited in the current study. Echocardiographic, cTNI,high sensitive C-reaction protein（hs-CRP） ,NT-proBNP were measured. Fifty-two patients were followed up for a mean of 6 months. Results The PPCM patients （29. 5 ± 6. 4） yrs were older than the controls （25. 2 ± 5. 8） yrs （P〈0.01） . Compared to the controls, the PPCM patients showed higher blood pressure （146.9/98. 8 mm Hg v. s. 130. 2/80. 1 mm Hg, P 〈 0. 01） , higher proportion of cesarean section （65. 9% v. s. 51. 0% , P 〈 0. 05） and complicated infection（75. 6% v. s. 10. 0% ,P 〈0. 01）. The level of leucocyte（11.0 × 109/L） ,cTNI（0. 17 μg/L）, hs-CRP（28. 2 mg/L）and NT-proBNP（650. 1 ng/L） were significantly higher in the PPCM patients compared with control（8. 8 × 109/L,0. 06μg/L,6. 2 mg/L and 110. 5 ng/L,P 〈0. 01）. Hs-CRP was positively related with NT-proBNP（r = 0. 67, P 〈 0. 01）. After average of 6 months of treatment, left ventricular ejection fraction enhanced from 32. 2% to 50. 6%. NT-proBNP significantly declined from 650. 1 ng/L to 225.6 ng/L（P 〈0. 01）. Multiple linear regression analysis showed that diastolic pressure （P 〈 0. 05）, LVED （P 〈 0. 05） and hs-CRP （P 〈 0. 05） were the independent predictors for declined NT-proBNP. Conclusions Inflammatory plays an important role in the development of peripartum cardiomyopathy.
出处
《中国综合临床》
2010年第6期640-642,共3页
Clinical Medicine of China
关键词
围生期心肌病
炎症
Peripartum cardiomyopathy
Inflammatory
