目的 追踪观察12例20～45岁女性慢性心力衰竭加重是否与月经周期有关.方法 12例患者分别在黄体期及排卵后期增加同样剂量利尿剂及β-受体阻断剂至来潮,观察患者月经来潮前1～3 d心电图、症状、体征的变化.结果 月经来潮前1周(黄体期)开始增加利尿剂及β-受体阻断剂的剂量至月经来潮,治疗后患者期前收缩例数减少5例(44％),劳力性呼吸困难例数减少7例(58％),夜间阵发性呼吸困难减少3例(60％),双下肺罗音及下肢浮肿例数各减少7例(58％)；月经来潮前2周(排卵后期)开始增加同剂量利尿剂及β-受体阻断剂至月经来潮,治疗后患者期前收缩例数减少8例(78％),劳力性呼吸困难例数减少10例(83％),夜间阵发性呼吸困难减少5例(100％),双下肺啰音及下肢浮肿例数各减少10例(83％).结论 月经周期雌激素水平升高是女性慢性心力衰竭加重的诱因.%Objective To investigate the severity of 12 females (20-45 years old) with chronic heart failure (CHF), and whether the CHF symptoms worsened with menstrual cycle. Methods Twelve patients were given increased dose of diuretics and beta blockers in corpus hiteum stage and late ovulation until menstruation. The electrocardiogram, symptoms and signs of the patients are observed 1-3 days before menstruation. Results The 12 patients received increased diuretics and beta blockers one week before menstruation. After treatment, the number of patients with premature beat decreased 5 (44%), that with difficulty breathing after exertion reduced 7 (58%), with difficulty breathing paroxysmal at night reduced 3 (60%), and that of double down lung and lower limb swelling number both reduced 7 (58%). After treated by increased diuretics and beta blockers for 2 week before menstruation (ovulation later), the number of patients with premature beat decreased 8 (78%), that with difficulty breathing after exertion reduced 10 (83%), with difficulty breathing paroxysmal at night reduced 5 (100%), and that of double down lung and lower limb swelling number both reduced 10 (83%). Conclusion The increase of estrogen levels during menstrual cycle is the inducement of chronic heart failure.
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