超声心动图对妊娠期糖尿病孕妇的右心功能评估  

Evaluation of Right Ventricular Function in Pregnant Women With Gestational Diabetes Mellitus by Echocardiography

作　　者：谢敏[1] 罗平香 詹春仙 刘敏[1] XIE Min;LUO Pingxiang;ZHAN Chunxian;LIU Min(Ultrasound Department,Fujian Maternity and Child Health Hospital,Fuzhou Fujian 350001,China;Neonatology Department,Fujian Maternity and Child Health Hospital,Fuzhou Fujian 350001,China)

机构地区：[1]福建省妇幼保健院超声科,福建福州350001 [2]福建省妇幼保健院新生儿科,福建福州350001

出　　处：《中国卫生标准管理》2020年第22期51-54,共4页China Health Standard Management

摘　　要：目的分析血糖水平对妊娠糖尿病孕妇右心功能的影响。方法选择2019年3月—2020年3月于我院诊断妊娠期糖尿病孕妇75例,根据孕妇妊娠期血糖控制水平分为GDM-I组35例,GDM-II组40例。另取同期正常妊娠孕妇50例作为对照组,对其进行常规超声心动图检查,检测右心二维超声结构变化,测取右心房、右心室左右径,右心房上下径及三尖瓣环收缩期位移(tricuspid annular plane systolic excursion,TAPSE)和右室流出道短轴缩短率(shortening rate of short axis of right ventricular outflow tract,RVOT-FS),测取心脏三尖瓣口血流频谱多普勒、三尖瓣环组织多谱勒,获取三尖瓣口舒张早期、晚期血流峰值流速E和A、三尖瓣环右心室侧壁组织多普勒收缩期及舒张期运动峰值速度Sa、E’峰及等容收缩时间(isovolumetric contraction time,IVCT)、等容舒张时间(isovolumic relaxation time,IVRT)和射血时间(ejection time,ET),计算E/A比值、E/E’比值和心肌做功指数(Tei指数)。结果两组GDM患者E/A及E/E’比值较对照组降低,差异具有统计学意义(P<0.05),GDM-I组中Tei指数与正常对照组比较差异具有统计学意义(P<0.05),三组间各项收缩功能指标及右心形态学无差异。结论妊娠期糖尿病患者随着病程的发展,右心室舒张功能的降低早于收缩功能的减退,且早期右心构型可无改变,Tei指数能够早期检测出右心整体功能的受损。0bjective To analyze the effect of blood glucose level on right ventricular function in pregnant women with gestational diabetes mellitus.Methods 75 pregnant women with gestational diabetes diagnosed in our hospital from March 2019 to March 2020 were selected.According to the blood glucose control level during pregnancy,40 cases were divided into the GDM-II group and 35 cases were divided into the GDM-I group,another 50 cases of normal pregnant women in the same period were taken as the control group.Echocardiography was performed to detect the structure changes of the right ventricle,as atrium and ventricle diameter,tricuspid annulus systolic displacement(TAPSE)and right ventricular outflow tract short axis shortening rate(RVOT-FS)were measured,the cardiac blood flow Doppler and tissue Doppler analysisd of cardiac diastolic function index of E/A,E/E'ratio changes,Tei index are calculated simultaneously.Results The E/A and E/E'ratios of GDM patients in both two groups were significantly lower than those in the control group(P<0.05),as the Tei index in the GDM-I group was significantly different from the control group(P<0.05).There was no significant difference in contractile function and ventricular morphology between the three groups.Conclusion With the development of gestational diabetes,the diastolic function of the right ventricle decreased earlier than the systolic,while there may no significant change in the heart configuration.Tei index could early detect the impairment of the overall function of the right heart.

关 键 词：超声心动图 妊娠期糖尿病 血糖 右心功能 心脏构型 TEI指数 

分 类 号：R714[医药卫生—妇产科学]