Circ-Heart Fail:子痫前期对围产期心肌病妇女的临床和功能结局的影响如何?

2017-06-03 xing.T MedSci原创

由此可见,相比于不伴有子痫前期的PPCM患者,PPCM合并子痫前期与发病率和死亡率增加相关,并且与不同的LV重构模式以及左室功能恢复相关。

子痫前期是围产期心肌病(PPCM)发生的一个危险因素,但子痫前期是否会影响临床或左心室(LV)功能结局尚不清楚。近日,心血管领域权威杂志Circ-Heart Fail上发表了一篇研究文章,该研究旨在评估在PPCM合并子痫前期患者的临床和功能结局。

这项回顾性队列研究纳入了诊断为PPCM并且于2004年至2014年期间在巴尼斯犹太医院分娩的女性。该研究的主要终点为联合死亡和再住院的一年无事件生存率。次要终点是左室射血分数恢复。

39例PPCN女性中有17例(44%)患者发生子痫前期。诊断时各组有相似的平均LV射血分数(子痫前期29.6 vs. 无子痫前期27.3,P=0.5)。子痫前期妇女的平均LV舒张末期直径较小(5.2 vs. 6cm,P=0.001),相对壁厚度较厚(0.41 vs. 0.35mmHg,P=0.009)以及离心性重塑的发生率较低(P=0.03)。研究人员对32例妇女进行了临床随访,5例患者在诊断后一年内死于心血管并发症(子痫前期4/15 vs. 无子痫前期1/17,P=0.16)。在事件时间分析中,子痫前期患者在随访1年期间,无事件生存率更糟糕(P=0.047)。超声心动图随访了10例子痫前期患者和16例无子痫前期患者。80%子痫前期患者LV射血分数得到了恢复,25%的无子痫前期患者LV射血分数得到了恢复(P=0.014)。

由此可见,相比于不伴有子痫前期的PPCM患者,PPCM合并子痫前期与发病率和死亡率增加相关,并且与不同的LV重构模式以及左室功能恢复相关。

原始出处:

Kathryn J. Lindley,et al. Impact of Preeclampsia on Clinical and Functional Outcomes in Women With Peripartum Cardiomyopathy. Circulation:heart failure. 2017. https://doi.org/10.1161/CIRCHEARTFAILURE.116.003797

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    2017-06-05 1351efe3b9m

    好了

    0

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  4. 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createdName=1351efe3b9m, createdTime=Mon Jun 05 15:55:39 CST 2017, time=2017-06-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1301067, encodeId=8434130106e62, content=<a href='/topic/show?id=10333293491' target=_blank style='color:#2F92EE;'>#功能结局#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=32934, encryptionId=10333293491, topicName=功能结局)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d275294, createdName=andy2087, createdTime=Mon Jun 05 11:29:00 CST 2017, time=2017-06-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1356310, encodeId=cb0a13563108e, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Mon Jun 05 11:29:00 CST 2017, time=2017-06-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1366552, encodeId=164d1366552a6, content=<a href='/topic/show?id=097a452219b' target=_blank style='color:#2F92EE;'>#子痫前期#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=45221, encryptionId=097a452219b, topicName=子痫前期)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=52c7237, createdName=yahu, createdTime=Mon Jun 05 11:29:00 CST 2017, time=2017-06-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1562548, encodeId=487f156254830, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=80d715270048, createdName=slcumt, createdTime=Mon Jun 05 11:29:00 CST 2017, time=2017-06-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1622265, encodeId=539a1622265cb, content=<a href='/topic/show?id=b9578094833' target=_blank style='color:#2F92EE;'>#肌病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=80948, encryptionId=b9578094833, topicName=肌病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=395f25, createdName=爆笑小医, createdTime=Mon Jun 05 11:29:00 CST 2017, time=2017-06-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=206779, encodeId=c005206e79a5, content=认真学习,不断进步,把经验分享给同好。点赞了!, 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GetPortalCommentsPageByObjectIdResponse(id=206257, encodeId=f30a20625e77, content=学习了,感谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/1103841572/C20CB8E4EBB36F5B821651C710BCB491/100, createdBy=18de1715848, createdName=lofter, createdTime=Sun Jun 04 07:43:01 CST 2017, time=2017-06-04, status=1, ipAttribution=)]
    2017-06-05 zhaojie88
  5. [GetPortalCommentsPageByObjectIdResponse(id=1933278, encodeId=a17319332e873, content=<a href='/topic/show?id=a2f04062973' target=_blank style='color:#2F92EE;'>#围产期心肌病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=40629, encryptionId=a2f04062973, topicName=围产期心肌病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=86b7385, createdName=lqrandywkz, createdTime=Wed Jul 12 15:29:00 CST 2017, time=2017-07-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=206876, encodeId=5cda2068e6e7, content=好了, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfU79IXHF4h2OoaZH3uj2wL4pcgUhydBZZia8qyXR1GZtkoPsibWjfVtnkvy4xksibpNs89oxOtFiaVj2DRXl6eUEoR/0, createdBy=d9002069981, 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level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=80d715270048, createdName=slcumt, createdTime=Mon Jun 05 11:29:00 CST 2017, time=2017-06-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1622265, encodeId=539a1622265cb, content=<a href='/topic/show?id=b9578094833' target=_blank style='color:#2F92EE;'>#肌病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=80948, encryptionId=b9578094833, topicName=肌病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=395f25, createdName=爆笑小医, createdTime=Mon Jun 05 11:29:00 CST 2017, time=2017-06-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=206779, encodeId=c005206e79a5, content=认真学习,不断进步,把经验分享给同好。点赞了!, 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GetPortalCommentsPageByObjectIdResponse(id=206257, encodeId=f30a20625e77, content=学习了,感谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/1103841572/C20CB8E4EBB36F5B821651C710BCB491/100, createdBy=18de1715848, createdName=lofter, createdTime=Sun Jun 04 07:43:01 CST 2017, time=2017-06-04, status=1, ipAttribution=)]
    2017-06-05 yahu
  6. [GetPortalCommentsPageByObjectIdResponse(id=1933278, encodeId=a17319332e873, content=<a href='/topic/show?id=a2f04062973' target=_blank style='color:#2F92EE;'>#围产期心肌病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=40629, encryptionId=a2f04062973, topicName=围产期心肌病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=86b7385, createdName=lqrandywkz, createdTime=Wed Jul 12 15:29:00 CST 2017, time=2017-07-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=206876, encodeId=5cda2068e6e7, content=好了, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfU79IXHF4h2OoaZH3uj2wL4pcgUhydBZZia8qyXR1GZtkoPsibWjfVtnkvy4xksibpNs89oxOtFiaVj2DRXl6eUEoR/0, createdBy=d9002069981, 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level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=80d715270048, createdName=slcumt, createdTime=Mon Jun 05 11:29:00 CST 2017, time=2017-06-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1622265, encodeId=539a1622265cb, content=<a href='/topic/show?id=b9578094833' target=_blank style='color:#2F92EE;'>#肌病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=80948, encryptionId=b9578094833, topicName=肌病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=395f25, createdName=爆笑小医, createdTime=Mon Jun 05 11:29:00 CST 2017, time=2017-06-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=206779, encodeId=c005206e79a5, content=认真学习,不断进步,把经验分享给同好。点赞了!, 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GetPortalCommentsPageByObjectIdResponse(id=206257, encodeId=f30a20625e77, content=学习了,感谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/1103841572/C20CB8E4EBB36F5B821651C710BCB491/100, createdBy=18de1715848, createdName=lofter, createdTime=Sun Jun 04 07:43:01 CST 2017, time=2017-06-04, status=1, ipAttribution=)]
    2017-06-05 slcumt
  7. 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GetPortalCommentsPageByObjectIdResponse(id=206257, encodeId=f30a20625e77, content=学习了,感谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/1103841572/C20CB8E4EBB36F5B821651C710BCB491/100, createdBy=18de1715848, createdName=lofter, createdTime=Sun Jun 04 07:43:01 CST 2017, time=2017-06-04, status=1, ipAttribution=)]
  8. 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GetPortalCommentsPageByObjectIdResponse(id=206257, encodeId=f30a20625e77, content=学习了,感谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/1103841572/C20CB8E4EBB36F5B821651C710BCB491/100, createdBy=18de1715848, createdName=lofter, createdTime=Sun Jun 04 07:43:01 CST 2017, time=2017-06-04, status=1, ipAttribution=)]
    2017-06-05 ylzr123

    认真学习,不断进步,把经验分享给同好。点赞了!

    0

  9. 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level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=80d715270048, createdName=slcumt, createdTime=Mon Jun 05 11:29:00 CST 2017, time=2017-06-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1622265, encodeId=539a1622265cb, content=<a href='/topic/show?id=b9578094833' target=_blank style='color:#2F92EE;'>#肌病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=80948, encryptionId=b9578094833, topicName=肌病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=395f25, createdName=爆笑小医, createdTime=Mon Jun 05 11:29:00 CST 2017, time=2017-06-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=206779, encodeId=c005206e79a5, content=认真学习,不断进步,把经验分享给同好。点赞了!, 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GetPortalCommentsPageByObjectIdResponse(id=206257, encodeId=f30a20625e77, content=学习了,感谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/1103841572/C20CB8E4EBB36F5B821651C710BCB491/100, createdBy=18de1715848, createdName=lofter, createdTime=Sun Jun 04 07:43:01 CST 2017, time=2017-06-04, status=1, ipAttribution=)]
    2017-06-05 大爰

    学习并分享!!!

    0

  10. 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GetPortalCommentsPageByObjectIdResponse(id=206257, encodeId=f30a20625e77, content=学习了,感谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/1103841572/C20CB8E4EBB36F5B821651C710BCB491/100, createdBy=18de1715848, createdName=lofter, createdTime=Sun Jun 04 07:43:01 CST 2017, time=2017-06-04, status=1, ipAttribution=)]
    2017-06-04 lofter

    学习了,感谢分享!

    0

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子痫前期指怀孕前血压正常、妊娠20周以后出现高血压、蛋白尿;是妊娠期高血压疾病的五种状况之一,为妊娠期特发疾病,可影响机体各器官系统。目前其发病率约占全部妊娠的8%。 越来越多的证据表明,母亲、胎盘和胎儿之间存在性别特异性的相互作用,可能会导致孕期不同的适应机制。 我们进行了一项荟萃分析,探究胎儿性别和子痫前期之间的联系,此外重点关注了子痫前期患者分娩时的孕周。 本研究纳入了21

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美国预防服务工作组(USPSTF)对之前发布的声明草案进行了重申:呼吁孕期常规进行子痫前期的筛查。 关于血压测量对孕妇子痫前期筛查的益处,得到了机构的“适度”的肯定,推荐等级为B。 在对子痫前期检测方式进行评估时,USPSTF认为有足够的证据支持血压测量的准确度;此外,还有足够的证据表明,蛋白尿检测时,使用试纸测试尿蛋白的诊断准确率低。 在评估早期检测和治疗子痫前期的利弊时,有足

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子痫前期,特别严重的或是早发型子痫前期、妊娠后几十年母亲视网膜疾病发生高风险相关。

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sFlt-1:PLGF比值为未经选择的单胎妊娠初产妇出现子痫前期最重要的临床表现的预测提供了有用的临床风险预测指标。