妊娠期糖尿病孕妇胎儿心脏构型及心功能评估研究  

Evaluation research on fetal cardiac geometric alteration and cardiac function of pregnant women with GDM

作　　者：董娟[1] 李晓琴[1] Dong Juan;Li Xiaoqin(Department of Ultrasonography, Shiyan Maternal and Child Health Hospital, Shiyan, Hubei, 442000, Chin)

机构地区：[1]十堰市妇幼保健院超声科,湖北十堰442000

出　　处：《西南国防医药》2018年第3期212-214,共3页Medical Journal of National Defending Forces in Southwest China

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 receiv

关 键 词：超声心动图 妊娠期糖尿病 胎儿 心脏构型 心功能 

分 类 号：R714.2[医药卫生—妇产科学]