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围生期心肌病的病因、临床表现及诊断

Authors
Wendy Tsang, MD
Amy C Bales, MD
Roberto M Lang, MD
Section Editor
Candice Silversides, MD, MS, FRCPC
Deputy Editor
Susan B Yeon, MD, JD, FACC
Translators
王涛, 主治医师

引言

围生期心肌病(peripartum cardiomyopathy, PPCM)，亦称妊娠相关性心肌病(pregnancy-associated cardiomyopathy, PACM)，是在妊娠晚期或产褥期早期导致孕产妇发生心力衰竭(heart failure, HF)的罕见病因[1]。虽然早在1849年对此病就有描述[2]，但直到20世纪30年代才认识到它是一种单独的临床疾病[3]。此病以前还曾被称为中毒性产后HF、Meadows综合征、Zaria综合征和产后心肌炎。

本专题将讨论PPCM的病因、临床表现及诊断。PPCM的治疗和预后、妊娠期及围产期危重症疾病、妊娠期HF，以及先天性或获得性心脏疾病女性的妊娠相关问题参见其他专题。 (参见“围生期心肌病：治疗和预后”和“妊娠期及围产期危重病”和“妊娠期心力衰竭的处理”和“获得性心脏疾病与妊娠”和“先天性心脏病女性患者的妊娠：一般原则”)

定义

已有多种定义被用于界定PPCM[1,4-7]。我们赞同2010年欧洲心脏病学会(European Society of Cardiology, ESC)围生期心脏疾病工作组制定的定义[1]。该工作组通过采用一种宽泛的定义来力图避免漏诊PPCM，该定义也被纳入了2011年ESC关于妊娠期心血管疾病的治疗指南[1,7]。

2010年ESC工作组将PPCM定义为一种具有如下特征的特发性心肌病：

●HF发生于妊娠即将结束时或者分娩后数月内。

                        

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Literature review current through: 2017-06 . | This topic last updated: 2016-02-26.
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