常规和斑点追踪超声心动图对妊娠糖尿病患者胎儿心脏功能的评估  

Evaluation of fetal heart function in patients with gestational diabetes mellitus by conventional and speckle tracking echocardiography

作　　者：高雅 向绍建 李晶晶 余祯秀 GAO Ya;XIANG Shaojian;LI Jingjing;YU Zhenxiu(Department of Obstetrics,Chongqing University Three Gorges Hospital,Chongqing 404100,China;Department of Ultrasound,Chongqing University Three Gorges Hospital,Chongqing 404100,China)

机构地区：[1]重庆大学附属三峡医院产科,重庆404100 [2]重庆大学附属三峡医院超声科,重庆404100

出　　处：《中国优生与遗传杂志》2022年第5期840-843,共4页Chinese Journal of Birth Health & Heredity

摘　　要：目的探讨常规和二维斑点追踪超声心动图(2D-STE)对妊娠糖尿病(GDM)患者胎儿心脏功能的评估。方法选择2019年8月至2021年8在本院产科门诊就诊的孕产妇169例为研究对象。根据诊断结果分为GDM组79例,对照组90例。采用常规超声心动图评估胎儿心脏形态、收缩及舒张功能,采用2D-STE评估胎儿心室应变。结果与对照组比较,GDM组孕产妇体质量及BMI升高(P<0.05);GDM组胎儿左心房面积、左心输出量降低,室间隔厚度升高(P<0.05);GDM组胎儿左心室舒张早期应变率(LVSRe)、左心室舒张晚期应变率(LVSRa)、右心室整体纵向峰值应变、右心室舒张早期应变率、右心室舒张晚期应变率降低(P<0.05)。未治疗GDM组胎儿左心室整体纵向峰值应变(LVGLS)、LVSRe、LVSRa降低(P<0.05)。治疗GDM组胎儿LVSRa降低,LVGLS、LVSRe较未治疗GDM组升高(P<0.05)。结论GDM胎儿表现出双心室舒张功能和右心室收缩功能障碍变化。2D-STE可提供额外的心肌变形分析,有助于评估发育过程中胎儿的健康状况。Objective To explore the evaluation of fetal heart function in patients with gestational diabetes mellitus(GDM)by conventional and two-dimensional speckle tracking echocardiography(2D-STE).Methods A total of 169 pregnant women who attended the obstetric clinic of our hospital from August 2019 to August 2021 were selected as the research objects.According to the diagnosis results,they were divided into GDM group with 79 cases and control group with 90 cases.The fetal heart morphology,systolic and diastolic function were assessed by conventional echocardiography,and the fetal ventricular strain was assessed by 2D-STE.Results Compared with the control group,the maternal weight and BMI in the GDM group increased(P<0.05);the fetal left atrial area and left ventricular output in the GDM group decreased,and the ventricular septal thickness increased(P<0.05).The fetal left ventricular early diastolic strain rate(LVSRe),left ventricular late diastolic strain rate(LVSRa),right ventricular global longitudinal peak strain,right ventricular early diastolic strain rate,and right ventricular late diastolic strain rate in the GDM group decreased(P<0.05).The left ventricular global longitudinal peak strain(LVGLS),LVSRe and LVSRa of the fetus in the untreated GDM group decreased(P<0.05).The Fetal LVSRa decreased in the treated GDM group,while the LVGLS and LVSRe increased compared with the untreated GDM group(P<0.05).Conclusions The fetus of GDM patients showed changes in diastolic function of both ventricles and systolic dysfunction of right ventricle.The 2D-STE could provide additional analysis of myocardial deformation and help assess the health of the fetus during development.

关 键 词：妊娠糖尿病 二维斑点追踪超声心动图 心脏功能 胎儿 

分 类 号：R714.256[医药卫生—妇产科学] R714.5[医药卫生—临床医学]