超声心动图评价妊娠期糖尿病胎儿心脏功能

目的 应用超声心动图评价妊娠期糖尿病(GDM)胎儿心脏构型及功能变化.资料与方法 48例GDM孕妇按照母体血糖水平分为GDM 1组和GDM 2组,应用超声心动图测量胎儿心脏二尖瓣环内径(MVA)、三尖瓣环内径(TVA)、主动脉瓣环内径(AVA)、肺动脉瓣环内径(PVA)、左/右室舒张末期内径(LVDd、RVDd)、左/右室收缩末期内径(LVDs、RVDs)、左/右室壁厚度(LVWT、RVWT)、室间隔舒张末期厚度(IVSd)、室间隔收缩末期厚度(IVSs)、左室射血分数(LVEF)、左/右室短轴缩短率(LVFS、RVFS)、二、三尖瓣E、A峰值速度比值(E/AMV、E/ATV)、左/右室Tei指数(LVMPI、RVMPI).选择同期96例正常妊娠孕妇作对照.结果 GDM 2组胎儿MVA、TVA、PVA、LV MPI、RV MPI均大于对照组,差异有统计学意义(P＜0.05).GDM 1组胎儿MVA、TVA、AVA、PVA和RV MPI均小于GDM2组,差异有统计学意义(P＜0.05).GDM1组各瓣环内径与对照组差异无统计学意义(P＜0.05)；LV MPI、RV MPI较对照组增大,差异有统计学意义(P＜0.05).结论 母体血糖水平越高,胎儿心脏构型及功能改变越明显.超声心动图是评价妊娠期糖尿病胎儿心脏功能的重要方法.

Evaluation of Fetal Heart Function of Gestational Diabetes by Echocardiography

Purpose To evaluate the impact of gestational diabetes mellitus on fetal cardiac development by using echocardiography.Materials and Methods Fortyeight fetuses of gestational diabetic mothers were divided into GDM1 group and GDM2 group according to blood glucose.Ninety-six normal fetuses were included as controls.Echocardiography was performed and the following variables were studied,including MVA,TVA,AVA,PVA,LVDd,RVDd,LVDs,RVDs,LVWT,RVWT,IVSd,IVSs,LVEF,LVFS,RVFS,E/A MV,E/A TV,LV MPI and RV MPI.The results were compared with that of the control group.Results The fetuses of GDM2 group had larger MVA,TVA,PVA,LV MPI and RV MPI than those of the control group (P <0.05).The fetuses of GDM2 group had larger MVA,TVA,AVA,PVA and RV MPI when compared with those of GDM1 group (P< 0.05).There was no significant difference in MVA,TVA,AVA and PVA between the fetuses of the control group and GDM1 group (P >0.05).The fetuses of GDM1 group had higher LV MPI and RV MPI than those of the control group (P <0.05).Conclusion Fetal cardiac geometry and function are affected by glucose levels.Echocardiography is an important method for evaluating fetal cardiac function in gestational diabetes.