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胎儿完全性房室传导阻滞13例随访分析

Follow-up analysis of 13 fetuses with complete atrioventricular conduction block
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摘要 目的 探讨胎儿完全性房室传导阻滞(complete atrioventricular conduction block,CAVB)的临床特点及预后。方法 选择2012年1月至2022年8月,联勤保障部队第九〇〇医院诊断的13例胎儿CAVB进行回顾性分析,对其临床特点、治疗及转归情况进行分析。结果 共纳入13例CAVB胎儿,7例终止妊娠,6例存活。7例终止妊娠胎儿中6例合并心功能降低,5例存在心脏结构异常,4例患儿母亲抗核抗体(ANA)、干燥综合征抗原A(SSA)抗体阳性。6例存活胎儿中1例合并心功能降低,2例存在心脏结构异常,5例患儿母亲ANA、SSA抗体阳性。1例患儿出生后静息心室率42~45次/min,5岁时突发晕厥后植入永久性起搏器。1例患儿房间隔缺损、心室率<70次/min,2岁时接受房间隔缺损修补术,未植入起搏器。其余4例患儿心室率>52次/min,未植入起搏器。结论 心功能正常,且心脏结构正常的CAVB胎儿,若出生后无明显症状,多数预后较好,可暂不植入永久性起搏器。 Objective To explore the clinical characteristics and prognosis of fetuses with complete atrioventricular conduction block(CAVB). Methods The clinical characteristics, treatment and outcome of 13 fetal CAVB patients diagnosed by the 900 TH Hospital of Joint Logistics Support Force from January 2012 to August 2022 were retrospectively analyzed. Results A total of 13 CAVB fetuses were included, of whom 7 were terminated and 6 survived. Among the 7 terminated fetuses, 6 were complicated with decreased cardiac function, 5 had cardiac structural abnormalities, and mothers of 4 fetuses were positive for ANA and SSA antibodies. Among the 6 surviving fetuses, 1 case was complicated with decreased cardiac function, 2 cases had cardiac structural abnormalities, and mothers of 5 cases were positive for ANA and SSA antibodies. One child had a resting ventricular rate of 42-45 beats/min after birth. He was implanted with a permanent pacemaker because of sudden syncope at the age of 5 years. One patient had atrial septal defect with ventricular rate < 70 beats/min. He underwent atrial septal defect repair without pacemaker implantation at the age of 2 years. The remaining 4 patients had ventricular rate > 52 beats/min without pacemaker implantation. Conclusion If the CAVB fetus with normal cardiac function and normal cardiac structure has no obvious symptoms after birth, most of them have a good prognosis and permanent pacemaker implantation can be deferred.
作者 欧阳静娥 缪慧玉 邱亮华 王在钰 叶凤玲 林利利 陈揭剑 OUYANG Jing’e;MIAO Huiyu;QIU Lianghua;WANG Zaiyu;YE Fengling;LIN Lili;CHEN Jiejian(Department of Cardiology,900Th Hospital of Joint Logistics Support Force,PLA,Fuzhou 350025,Fujian,China;Department of Nephrology,900Th Hospital of Joint Logistics Support Force,PLA,Fuzhou 350025,Fujian,China)
出处 《临床儿科杂志》 CAS CSCD 北大核心 2023年第1期30-33,共4页 Journal of Clinical Pediatrics
基金 联勤保障部队第九〇〇医院2020年度医院科研计划(No.2020Z09)。
关键词 胎儿 完全性房室传导阻滞 永久性起搏器 fetus complete atrioventricular conduction block permanent pacemaker
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