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围生期心肌病：治疗和预后

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
周健, 副主任医师

引言

围生期心肌病(peripartum cardiomyopathy, PPCM，也称为妊娠相关性心肌病)是在妊娠晚期或产褥期早期导致女性心力衰竭(heart failure, HF)的一种罕见病因[1]。尽管最初在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独特的临床疾病[3]。此病较早的术语包括中毒性产后心力衰竭、Meadows综合征、Zaria综合征和产后心肌病。

PPCM的治疗与其他类型的心力衰竭伴左心室(left ventricular, LV)收缩功能障碍的治疗类似。然而，为了确保母亲和未出生或哺乳期孩子的安全，通常需要对标准治疗进行修改。 (参见“妊娠期心力衰竭的处理”，关于‘治疗目标’一节)

PPCM的病因、临床表现和诊断，妊娠期及围生期危重症疾病，妊娠期心力衰竭，以及获得性或先天性心脏疾病女性的妊娠相关问题将单独讨论。 (参见“围生期心肌病的病因、临床表现及诊断”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”)

治疗

PPCM的治疗在很大程度上与其他类型心力衰竭的治疗相似。其他治疗问题包括对心律失常的治疗。一项初步研究提示溴隐亭可能有用，但需要进一步的研究[4]。

心力衰竭的治疗

治疗组成 — 对于有PPCM和心力衰竭的女性，其内科治疗的目标与其他原因引起的急性和慢性收缩性心力衰竭患者的治疗目标相似。包括：

                   

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Literature review current through: 2017-06 . | This topic last updated: 2015-06-25.
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