2025 年第 5 期 第 20 卷

合并心律失常对孕产妇临床指标和妊娠结局的影响

The effect of combined arrhythmia on clinical indicators and pregnancy outcomes of pregnant women

作者：袁媛付越张军龚静

英文作者：Yuan Yuan Fu Yue Zhang Jun Gong Jing

单位：首都医科大学附属北京安贞医院妇产科，北京100029

英文单位：Department of Obstetrics and Gynecology Beijing Anzhen Hospital Capital Medical University Beijing 100029 China

关键词：心律失常；孕产妇；妊娠结局

英文关键词：Arrhythmia;Pregnantwomen;Pregnancyoutcome

• 摘要：

• 目的 探讨妊娠合并心律失常的情况及其对孕产妇妊娠结局的影响，以期为临床实践提供新思路和理论依据。方法 收集2019年1月1日至2023年12月31日于首都医科大学附属北京安贞医院产科分娩的287例孕产妇的临床资料进行回顾性分析。根据孕产妇是否合并心律失常分为心律失常组（142例）和非心律失常组（145例）。比较2组的一般资料、实验室检查指标及妊娠结局的差异。结果 心律失常组孕产妇年龄、孕前体重指数、孕次及先天性心脏病患病率大于/高于/多于非心律失常组，身高、孕周低于/小于非心律失常组，差异均有统计学意义（均P<0.05）。2组孕前体重、产次差异均无统计学意义（均P>0.05）。心律失常组孕产妇肌酸激酶同工酶、高密度脂蛋白胆固醇及C反应蛋白水平均高于非心律失常组，差异均有统计学意义(均P<0.05)，2组总胆固醇、低密度脂蛋白胆固醇水平差异均无统计学意义（均P>0.05）。心律失常组孕产妇剖宫产率、早产率及产后出血率均高于非心律失常组，自然分娩率低于非心律失常组［82.4%（117/142）比17.2%（25/145）、33.1%（47/142）比0（0）、17.6%（25/142）比0（0）、17.6%（25/142）比82.8%（120/145）］，差异均有统计学意义（均P<0.05）。结论 妊娠合并心律失常患者剖宫产、产后出血、早产等不良妊娠结局的风险提高，临床实践中应给予重视。

• Objective To explore the situation of pregnancy complicated with arrhythmia and its influence on the pregnancy outcome of pregnant women, in order to provide new ideas and theoretical basis for clinical practice. Methods The clinical data of 287 pregnant women who delivered in the Department of Obstetrics, Beijing Anzhen Hospital, Capital Medical University from January 1, 2019 to December 31, 2023 were collected and analyzed retrospectively. The pregnant women were divided into arrhythmia group (142 cases) and non-arrhythmia group (145 cases) according to whether they were complicated with arrhythmia. The differences in general data, laboratory tests indicators and pregnancy outcomes between the two groups were compared. Results The maternal age, pre-pregnancy body mass index, gravidity and prevalence of congenital heart disease in the arrhythmia group were greater/higher/more than those in the non-arrhythmia group, while the maternal height and gestational age were lower/less than those in the non-arrhythmia group (all P<0.05). There were no significant differences in pre-pregnancy body weight and parity between the two groups (both P>0.05). The levels of creatine kinase isoenzyme, high-density lipoprotein cholesterol and C-reactive protein in the arrhythmia group were higher than those in the non-arrhythmia group (all P<0.05). There was no significant difference in total cholesterol and low-density lipoprotein cholesterol between the two groups (all P>0.05). The rates of cesarean section, premature delivery and postpartum hemorrhage in the arrhythmia group were higher than those in the non-arrhythmia group, and the rate of natural delivery was lower than that in the non-arrhythmia group ［82.4%(117/142) vs 17.2%(25/145), 33.1%(47/142) vs 0(0), 17.6%(25/142) vs 0(0), 17.6%(25/142) vs 82.8%(120/145)］(all P<0.05). Conclusion Pregnant women with arrhythmia have an increased risk of adverse pregnancy outcomes such as cesarean section, postpartum hemorrhage, and premature delivery, which should be paid attention to in clinical practice.