压力-应变环评估妊娠期糖尿病孕妇分娩的新生儿左心室收缩功能研究  

Evaluation of left ventricular systolic function in neonates born to mothers with gestational diabetes mellitus by pressure strain ring

作　　者：苏莉莉 曹旭峰 牛海燕[2] 隋超 刘会芳 Su Lili;Cao Xufeng;Niu Haiyan;Sui Chao;Liu Huifang(Department of ultrasound,Shanxi Bethune Hospital,Shanxi Academy of Medical Sciences,Tongji Shanxi Hospital,the Third Hospital of Shanxi Medical University,Taiyuan,030032,China;不详)

机构地区：[1]山西白求恩医院(山西医学科学院同济山西医院),山西医科大学第三医院超声科,山西030032 [2]解放军总医院第七医学中心超声科,北京100700 [3]解放军总医院第七医学中心妇产医学部,北京100700

出　　处：《中国循证心血管医学杂志》2025年第1期115-119,共5页Chinese Journal of Evidence-Based Cardiovascular Medicine

摘　　要：目的应用无创左心室压力-应变环(LVPSL)评估妊娠期糖尿病(GDM)孕妇分娩的新生儿左心室收缩功能。方法收集中国人民解放军总医院第七医学中心GDM孕妇分娩的新生儿61例作为病例组,无妊娠期并发症孕妇分娩的健康新生儿30例作为对照组,根据GDM孕妇糖化血红蛋白(HbA1c)水平进一步将病例组分为HbA1c≤6.5%组(n=34)和HbA1c>6.5%组(n=27)。所有研究对象均于出生后24~48 h行超声心动图检查,通过斑点追踪技术获取整体纵向应变(GLS),压力-应变环(PSL)技术得出左心室心肌做功参数,包括整体做功指数(GWI)、整体有效功(GCW)、整体无效功(GWW)及整体做功效率(GWE)。比较三组间一般临床资料、常规超声心动图参数及左心室心肌做功参数,并分析GDM孕妇分娩新生儿左心室心肌做功参数与其母亲HbA1c的相关性。结果与对照组相比,HbA1c≤6.5%组及HbA1c>6.5%组新生儿体重增加,差异有统计学意义(P<0.05)。三组间左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)、左室后壁舒张末期厚度(LVPWD)、左室射血分数(LVEF)比较,差异无统计学意义(P>0.05)。与对照组相比,HbA1c≤6.5%组及HbA1c>6.5%组室间隔舒张末期厚度(IVSD)增厚,差异均有统计学意义(P<0.05),HbA1c≤6.5%组与HbA1c>6.5%组IVSD比较,差异无统计学意义(P=0.356)。与对照组相比,HbA1c≤6.5%组及HbA1c>6.5%组GLS、GWI、GCW均降低,差异有统计学意义(P<0.05);且与HbA1c≤6.5%组相比,HbA1c>6.5%组GLS、GWI、GCW降低更为明显,差异均有统计学意义(P<0.05)。三组之间GWW、GWE比较差异均无统计学意义(P>0.05)。Pearson相关性分析显示GDM孕妇分娩的新生儿GLS与其母亲HbA1c呈正相关(r=0.687,P<0.001),新生儿GWI、GCW与其母亲HbA1c呈负相关(r=-0.643,P<0.001;r=-0.627,P<0.001),新生儿GWW、GWE与其母亲HbA1c无相关性(P>0.05)。结论无创LVPSL能够定量评估GDM孕妇分娩的新生儿左心室心肌做功的变化,能早期、敏感反Objective To evaluate left ventricular systolic function in neonates born to mothers with gestational diabetes mellitus(GDM)by non-invasive left ventricular pressure-strain loop(LVPSL).Methods Sixty-one neonates born to mothers with GDM treated at the Seventh Medical Center of the General Hospital of the People's Liberation Army of China were collected as the case group,and thirty healthy neonates born to pregnant women without pregnancy complications were collected as the control group.According to the glycosylated hemoglobin(HbA1c)level of GDM women,the case group was further divided into HbA1c≤6.5%(n=34)and HbA1c>6.5%(n=27).Echocardiography was performed within 24~48 hours after birth.Global longitudinal strain(GLS)was obtained through the speckle tracking technology.PSL technology was used to obtain left ventricular myocardial work parameters,including global myocardial work index(GWI),global constructive work(GCW),global wasted work(GWW),and global myocardial work efficiency(GWE).The general clinical data,conventional echocardiography parameters,and myocardial work parameters of the left ventricle among three groups were compared,and the correlation between the left ventricular myocardial work parameters of neonates born to mothers with GDM and their mother's HbA1c was analyzed.Results Compared with the control group,the weight increased in the HbA1c≤6.5%group and HbA1c>6.5%group(P<0.05).Comparison of the left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD),left ventricular posterior wall thickness at end-diastole(LVPWD),and left ventricular ejection fraction(LVEF)among the three groups showed no statistically significant differences(P>0.05).Compared to the control group,both the HbA1c≤6.5%group and the HbA1c>6.5%group showed an increase in the interventricular septal thickness at end-diastole(IVSD),with statistically significant differences(P<0.05).However,there was no statistically significant difference in IVSD between the HbA1c≤6.5%group and the HbA1c>6.5%g

关 键 词：压力-应变环 妊娠期糖尿病 新生儿 左心室收缩功能 

分 类 号：R587.1[医药卫生—内分泌]