摘要
目的研究妊娠期糖尿病(GDM)孕妇胎儿心脏构型及心功能的变化。方法收集医院42例单胎GDM孕妇作为观察组,孕28~35 w,以是否需胰岛素治疗将其分为GDM-A组和GDM-B组,各21例。另选取同期来医院行孕期检查的30例健康孕妇为对照组。采用超声心动图观察各组胎儿心脏构型,分别测量胎儿的左室收缩/舒张末期内径(LVDs/LVDd)、右室收缩/舒张末期内径(RVDs/RVDd)、左/右室壁厚度(LVWT/RVWT)、左室射血分数(LVEF)、心脏二尖瓣环内径(MVA)、三尖瓣环内径(TVA)及二、三尖瓣E/A峰的速度比值(E/AMV、E/ATV)、心室Tei指数等指标。结果 (1)各组胎儿LVDs、LVDd水平无显著差异(P﹥0.05),但GDM-B组胎儿RVDs、RVDd、MVA、TVA显著高于GDM-A组及对照组(P<0.05),LVWT、RVWT虽与GDM-A组无显著差异(P﹥0.05),但显著高于对照组(P<0.05);(2)GDM-A组和GDM-B组胎儿LVEF高于对照组(P<0.05),E/AMV、E/ATV低于对照组(P<0.05),且GDM-B组LVEF水平显著高于GDM-A组(P<0.05),但两组胎儿E/AMV和E/ATV无显著差异(P﹥0.05);(3)GDM-A组和GDM-B组胎儿左室和右室Tei指数均高于对照组(P<0.05),且GDM-B组高于GDM-A组(P<0.05)。结论对需胰岛素干预治疗的GDM孕妇,应重视超声心电图对胎儿心脏构型及心功能的检查,并积极进行早期干预,以期改善妊娠结局。
Objective To study the fetal cardiac geometric alternation and cardiac function change of pregnant women with GDM. Methods A total of 42 single-birth pregnant women with GDM（gestational weeks： 28-35 w） admitted into our hospital were divided into a GDM-A group and a GDM-B group（n =21, respectively） according to whether or not an insulin therapy was needed.Another 30 healthy pregnant women visiting the hospital for pregnancy examination were selected to constitute a control group. UCG was performed to observe the fetal cardiac geometric alteration in every group, and measurements were performed on the fetal LVDs/LVDd, RVDs/RVDd, LVWT/RVWT, LVEF, MVA, TVA, E/AMV, E/ATV and ventricle Tei index. Results（1）No significant differences in LVDs and LVDd levels of fetuses among the groups were found（P〈0.05）; however, RVDs, RVDd, MVA and TVA levels of fetuses in the GDM-B group were significantly higher than those in the GDM-A group and the control group（P〈0.05）; although no significant differences in LVWT and RVWT levels were found from the GDM-A group（P〈0.05）, they were significantly higher than those in the control group（P〈0.05）;（2）fetuses in the GDM-A group and the GDM-B group had higher LVEF levels than those in the control group（P〈0.05） while E/AMV and E/ATV were lower than those in the control group（P〈0.05）; in particular, the GDM-B group had an LVEF level significantly higher than that in the GDM-A group（P〈0.05）, while there were no significant differences in E/AMV and E/ATV between the two groups（P〈0.05）;（3） left and right ventricle Tei indices of fetuses in the GDM-A group and the GDM-B group were higher than those in the control group（P〈0.05）, and those in the GDM-B group was higher than those in the GDM-A group（P〈0.05）. Conclusion Pregnant women with GDM needing insulin intervention should take the examination of fetal cardiac geometric alternation and cardiac function by means of ultrasonic cardiogram seriously and actively receive early intervention so as to improve the pregnancy outcome.
作者
董娟
李晓琴
Dong Juan;Li Xiaoqin(Department of Ultrasonography, Shiyan Maternal and Child Health Hospital, Shiyan, Hubei, 442000, Chin)
出处
《西南国防医药》
CAS
2018年第3期212-214,共3页
Medical Journal of National Defending Forces in Southwest China
关键词
超声心动图
妊娠期糖尿病
胎儿
心脏构型
心功能
ultrasonic cardiogram
GDM
fetus
cardiac geometric alteration
cardiac function
