胎儿超声心动图多参数评价母体糖代谢异常胎儿左心室舒张功能的研究  

Multiple fetal echocardiographic parameters for evaluation of fetal left ventricular diastolic function in women with gestational glucose metabolic abnormalities

作　　者：高珊珊[1] 赵博文[2] 彭晓慧[2] 王蓓[2] 潘美[2] 汤桐芳[2] 孙晓露[2] 邵璐[2] 

机构地区：[1]浙江省宁波市第二医院超声科,315010 [2]浙江大学医学院附属邵逸夫医院超声科浙江大学邵逸夫临床医学研究所,杭州310016

出　　处：《中华超声影像学杂志》2014年第12期1035-1039,共5页Chinese Journal of Ultrasonography

基　　金：浙江省科技厅公益性技术应用研究计划项目（2012C33123）

摘　　要：目的 探讨胎儿超声心动图多参数在母体糖代谢异常胎儿左室舒张功能定量评估中的价值.方法 68例母体糖代谢异常胎儿分为母体糖耐量异常（gestational impaired glucose tolerance,GIGT）组30例和妊娠期糖尿病（gestational diabetes mellitus,GDM）组38例,随机选取63例无母体糖代谢异常的胎儿作为对照组.脉冲多普勒获取胎儿肺静脉及二尖瓣口血流频谱参数,组织多普勒技术测量二尖瓣环运动峰值速度.GIGT胎儿、GDM胎儿与对照组间各参数进行统计学分析.结果 GIGT组和GDM组胎儿肺静脉搏动指数（pulsatility index,PI）值、A峰流速与对照组比较差异均有统计学意义（P＜0.05）;GIGT组与GDM组比较,PI值及A峰流速差异有统计学意义（P＜0.05）;二尖瓣口血流参数及二尖瓣瓣环运动参数分别进行组间比较差异均无统计学意义（P＞0.05）.结论 母体糖代谢异常会引起胎儿左室舒张功能改变,其受损程度与母体血糖水平相关;胎儿肺静脉PI值及A峰流速较传统参数在评价左室舒张功能方面更为敏感.Objective To explore the value of multiple fetal echocardiographic parameters in the quantitative evaluation of fetal left cardiac diastolic function with maternal glucose metabolic abnormalities.Methods Sixty-eight fetuses of maternal glucose metabolic abnormalities were divided into gestational impaired glucose tolerance （GIGT） group （30 cases） and gestational diabetes mellitus （GDM） group （38 cases）,and 63 normal fetuses were included as controls.Fetal echocardiograms were performed on these fetuses for evaluation of left cardiac diastolic function using pulsed Doppler echocardiography and myocardial tissue Doppler imaging.Each of the parameters was pair wise compared among three groups.Results The pulsatility index （PI） and A peak velocity of pulmonary vein in both GIGT group and GDM group revealed significant differences compared with controls （P ＜0.05）,these two indices of pulmonary vein Doppler parameters also demonstrated significant difference between GIGT group and GDM group （P ＜0.05）.Other echocardiographic parameters derived from mitral inflow Doppler and mitral annular DTI did not showed significant differences among three groups （P ＞ 0.05）.Conclusions Fetal left cardiac diastolic function is impaired in maternal glucose metabolic abnormalities.Fetal pulmonary veins PI and A peak velocity are more sensitive than traditional echocardiographic parameters in evaluating fetal left ventricular diastolic function.

关 键 词：超声心动描记术 葡萄糖代谢障碍 胎儿 心室功能 左 肺静脉 

分 类 号：R540.45[医药卫生—心血管疾病]