摘要
目的探讨抗心衰药物血管紧张素受体脑啡肽酶抑制剂(angiotensin receptor and neprilysin inhibitor,ARNI)应用于伴低血压状态的围产期心肌病患者的可能性。方法详细阐述2018年11月-2019年2月在该院诊治的1例30岁中年女性伴低血压状态的围产期心肌病的临床表现,诊断及治疗,并复习围产期心肌病诊治的相关文献,分析抗心衰药物ARNI在围产期心肌病中的应用可能。结果该例患者诊断为围产期心肌病伴心功能不全,且基础血压偏低,ACEI/ARB类药物不耐受,第1次常规治疗后患者心功能未能得到纠正再次入院。第2次在小剂量正性肌力药物强心升压的基础上,启用ACEI类药物,并根据血压情况,逐步调整为ARNI类药物,后患者心功能好转。结论抗心衰类药物ARNI在围产期心肌病治疗中的效果明确,能够有效改善患者心功能,且安全性较高,为围产期心肌病的治疗提供了新的思路。
Objective To investigate the possibility of anti-heart failure drug angiotensin receptor and neprilysin inhibitor (ARNI) in patients with peripartum cardiomyopathy with hypotension.Methods To elaborate the clinical manifestations,diagnosis and treatment of a 30-year-old middle-aged woman with hypotensive state of hypotension in our hospital from November 2018 to February 2019,and to review the diagnosis and treatment of peripartum cardiomyopathy related literature,analysis of the application of anti-heart failure drug ARNI in peripartum cardiomyopathy.Results The patient was diagnosed with perinatal cardiomyopathy with cardiac insufficiency,and the basal blood pressure was low.The ACEI/ARB drugs were intolerant.After the first routine treatment,the patient's cardiac function was not corrected and was admitted again.The second time,on the basis of the small dose of positive inotropic drugs,the ACEI drugs were activated,and according to the blood pressure,the ARNI drugs were gradually adjusted,and the heart function improved after the patients.Conclusion The anti-heart failure drug ARNI has a clear effect in the treatment of perinatal cardiomyopathy.It can effectively improve the heart function of patients and has high safety.It provides a new idea for the treatment of peripartum cardiomyopathy.
作者
王静
廖荣宏
WANG Jing;LIAO Rong-hong(Department of Cardiology, Xiamen Hospital, Zhongshan Hospital, Fudan University, Xiamen, Fujian Province, 361015 China;Department of Cardiology, Yongchuan Hospital, Chongqing Medical University, Chongqing, 402160 China)
出处
《中外医疗》
2019年第15期17-20,共4页
China & Foreign Medical Treatment
