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目的探讨合并心脏病的孕产妇发生心力衰竭的危险因素。方法回顾分析于河南省新乡医学院第一附属医院接受治疗的344例合并心脏病的孕产妇的临床资料,发生心力衰竭的61例患者作为观察组,同期未发生心力衰竭的258例患者作为对照组。给予发生心力衰竭的孕产妇急救治疗,并分别采用单因素、多因素Logistic回归法分析合并心脏病孕产妇并发心力衰竭的危险因素。结果基础心率>100次/min、先天性心脏病、围生期心肌病、风湿性心脏病、PAP>50 mm Hg、年龄≥35岁、孕前发生心脏事件、早孕期心功能分级≥Ⅱ级是心脏病孕产妇发生心力衰竭的独立危险因素(P<0.05),而孕前咨询和产前检查≥6次是其保护性因素(P<0.05)。结论合并心脏病孕产妇并发心力衰竭受多种因素影响,在临床中应对危险因素干预或规避,并帮助患者积极实现保护性因素,从而降低心力衰竭的发生率。
Objective To explore the risk factors of heart failure in pregnant women with heart disease. Methods The clinical data of 344 pregnant women with heart disease who were treated in the First Affiliated Hospital of Xinxiang Medical College of Henan Province were retrospectively analyzed. Among them, 61 patients with heart failure as the observation group and 258 patients without heart failure over the same period as the control group. Give first aid treatment of pregnant women with heart failure, and use single factor, multivariate logistic regression analysis to analyze the risk factors of heart failure complicating heart disease. Results heart rate> 100 beats / min, congenital heart disease, perinatal cardiomyopathy, rheumatic heart disease, PAP> 50 mm Hg, age ≥35 years, cardiac events before pregnancy, early pregnancy heart function grade ≥ Ⅱ grade Independent risk factors of heart failure in pregnant women with heart disease (P <0.05), and pre - pregnancy counseling and prenatal care ≥ 6 times were protective factors (P <0.05). Conclusions Pregnant women with heart disease complicated by heart failure are affected by many factors. They should intervene or avoid risk factors in clinical practice, and help patients to achieve protective factors positively so as to reduce the incidence of heart failure.