围产期心肌病

Proceedings of diagnosis and treatment of peripartum cardiomyopathy

围产期心肌病是妊娠期出现的一种相对少见的心肌病,以左室收缩功能减低并引起心力衰竭为主要表现。该病的发病机制尚不明确。研究显示,氧化应激及泌乳素的16 kU片段在围产期心肌病的发生中有重要意义。由于患者处于妊娠期或产后哺乳期,药物选择要考虑对胎儿的影响,保证母亲及胎儿的用药安全。拮抗泌乳素的药物可能是该病特异性的治疗药物。

Peripartum cardiomyopathy （PPCM）, also known as perinatal cardiomyopathy, has been the minority of myocar dial diseases in which heart failure was involved as a result of reduced left ventricular systolic capacity in previously healthy women. The pathogenesis of PPCM has not been wellunderstood although implicated to be associated with viral,inflammato ry, autoimmune and genetic anomalies. Oxidative stress and the 16 kU fragment of prolactin might play a key role in the pathogenesis of PPCM, as evidenced by recent studies. Owing to particular concerns of gestation or postpartum lactation, po tential impact of medications to the fetus should not be neglected while securing safety of both mother and fetus, despite sim ilar principles applied for treatment of heart failure induced by miscellaneous causes. In view that prolactin putatively corre lated with pathogenesis of PPCM, medications that act via blockade of prolactin might appear to be a diseasespecific ap proach.