糖尿病母亲的婴儿临床心脏病变情况  

Follow-up of infants of diabetic mother combined with heart disease

作　　者：齐宇洁[1] 刘红[1] 吴海兰[1] 翁景文[1] 董世霄[1] 靳绯[1] 刘靖媛[1] 

机构地区：[1]首都医科大学附属北京儿童医院新生儿中心,100045

出　　处：《中华实用儿科临床杂志》2014年第13期1014-1016,共3页Chinese Journal of Applied Clinical Pediatrics

摘　　要：目的 了解妊娠期糖尿病母亲的婴儿（IDM）的心脏结构、心肌肥厚及转归,加强对IDM心脏病变的认识.方法 选取2012年2月至2013年1月首都医科大学附属北京儿童医院NICU收治的IDM 23例作为观察组,随机选取同期同胎龄非IDM 23例作为对照组.对选取的各组新生儿出生后1周进行超声心动图检测,其测量室间隔厚度、左心室后壁厚度、主动脉瓣环内径、右心室前后径、射血分数及是否存在畸形.并于出生后3个月、6个月进行超声心动图复查随访.结果 出生后1周IDM组患儿室间隔厚度[（3.20±0.28）mm]、左心室后壁厚度[（3.40±0.31） mm]均高于对照组,射血分数[（54.00±3.76） ×10^-2]较对照组降低,差异均有统计学意义（P均＜0.05）.出生后3个月、6个月随访时,室间隔厚度、左心室后壁厚度、射血分数恢复至正常.IDM组先天性心脏病发病率高,23例中4例（17.4％）合并心脏发育畸形.结论 妊娠期IDM合并先天性心脏病发病率高,出生后应常规进行超声心动图检查,以识别肥厚型心肌病和其他形式的先天性心脏病.IDM合并心肌肥厚呈-过性良性改变,动态随访观察均恢复正常,预后良好.Objective To investigate the cardiac structure and hypertrophic cardiomyopathy of infant of diabetic mother（IDM）,to analyze of the outcome of hypertrophic cardiomyopathy in IDM.Methods Totally 23 cases of IDM admitted in NICU from Feb.2012 to Jan.2013 were selected as observation group,randomly selected from the same period with gestational age of diabetic mother baby 23 cases as control group.The interventricular septum thickness,left ventricular posterior wall thickness,aortic valve internal diameter,right ventricular diameter,ejection fraction were detected and compared between the 2 groups.And echocardiography was followed up in 3 months and 6 months old.Results In IDM group,interventricular septum thickness [（3.20 ± 0.28） mm],left ventricular posterior wall thickness [（3.40 ± 0.31） mm] were significantly higher than those in control group （all P 〈 0.05）.Ejection fraction [（54.00 ± 3.76） × 10^-2] was significantly lower than that in control group（P 〈 0.05）.Follow-up after 3 months,6 months old,interventricular septum thickness,left ventricular posterior wall thickness and ejection fraction returned to normal.Four of the 23 cases（17.4%） had cardiac malformations.Conclusions IDM has high morbidity of congenital heart disease,echocardiography should be done to identify hypertrophic cardiomyopathy and congenital heart disease after birth.IDM combined with hypertrophic cardiomyopathy is a transient,benign process,prognosis is good.

关 键 词：糖尿病母亲婴儿 肥厚性心肌病 心脏畸形 

分 类 号：R714.7[医药卫生—妇产科学]