心脏病患者围生期心脏不良事件的发生状况及影响因素分析

Analysis on prevalence and influencing factors of adverse cardiac events during perinatal period among the patients with heart diseases

目的分析心脏病患者围生期心脏不良事件的发生状况并探讨其影响因素,为相关临床工作提供指导信息。方法选取2018年12月-2019年11月在宁波市鄞州人民医院顺利生产的女性心脏病患者150例为研究对象,回顾性分析其临床资料,将其中发生围生期心脏不良事件的47例患者作为观察组,未发生围生期心脏不良事件103例患者作为对照组。分析围生期心脏不良事件发生状况,对比分析两组患者的一般资料(年龄、孕次、产次、孕期增重、生产孕周、分娩方式)及疾病情况(心脏病种类、心功能分级、心脏手术史、肺动脉高压、糖尿病史、妊娠期高血压疾病),采用多因素Logistic回归分析判定影响因素。结果 150例女性心脏病患者中,围生期心脏不良事件发生率为31.3%(47/150),主要不良事件为心力衰竭、心律失常。两组患者年龄、孕期增重、生产孕周比较,差异均有统计学意义(均P<0.05);两组患者心功能分级、肺动脉高压、糖尿病史、妊娠期高血压疾病情况比较,差异均有统计学意义(均P<0.05)。多因素Logistic回归分析结果显示,年龄、孕期增重、心功能分级、肺动脉高压、糖尿病史、妊娠期高血压疾病是心脏病患者围生期心脏不良事件发生的影响因素(均P<0.05)。结论心脏病患者围生期心脏不良事件的发生率较高,其发生受到患者年龄、孕期增重、心功能分级、肺动脉高压、糖尿病史、妊娠期高血压疾病等多因素综合影响,对具有以上影响因素的患者应密切监护和合理治疗,降低心脏不良事件的发生率,保证母婴安全。

Objective To analyze the prevalence of adverse cardiac events during perinatal period among the patients with heart diseases,explore the influencing factors,provide guidance for related clinical work. Methods A total of 150 female patients with heart diseases giving birth to their babies in Ningbo Yinzhou People’s Hospital from December 2018 to November 2019 were selected as study object,the clinical data were analyzed retrospectively,then the female patients were divided into observation group (47 patients with adverse cardiac events during perinatal period) and control group (103 patients without adverse cardiac events during perinatal period),the onset of adverse cardiac events during perinatal period was analyzed. The general data (age,gravidity,parity,body weight gain during pregnancy,gestational week of delivery,delivery modes) and disease situation (types of heart diseases,cardiac functional grading,history of heart surgery,pulmonary arterial hypertension,history of diabetes,hypertensive disorder complicating pregnancy) in the two groups were compared and analyzed,the influencing factors were analyzed by multivariate Logistic regression model. Results Among 150 female patients with heart diseases,the incidence rate of adverse cardiac events during perinatal period was 31. 3% (47/150). The main adverse cardiac events included cardiac failure and arrhythmia. There were statistically significant differences in age,body weight gain during pregnancy,and gestational week of delivery between the two groups (P<0. 05). There were statistically significant differences in cardiac functional grading,the incidence rates of pulmonary arterial hypertension,history of diabetes,hypertensive disorder complicating pregnancy between the two groups (P<0. 05). Multivariate Logistic regression analysis showed that age,body weight gain during pregnancy,cardiac functional grading,pulmonary arterial hypertension,history of diabetes,hypertensive disorder complicating pregnancy were influencing factors of adverse cardiac events during perinatal period among the patients with heart diseases (P<0. 05). Conclusion The incidence rate of adverse cardiac events during perinatal period among the patients with heart diseases is relatively high,which is affected by multiple factors,such as age,body weight gain during pregnancy,cardiac functional grading,pulmonary arterial hypertension,history of diabetes,hypertensive disorder complicating pregnancy,the patients with the above-mentioned influencing factors should be monitored closely and treated reasonably to reduce the incidence rate of adverse cardiac events and ensure maternal and child safety.