Tei指数评估妊娠期糖尿病胎儿及出生后新生儿、婴儿整体心功能研究

目的:应用Tei指数探讨母体高血糖环境对胎儿及其出生后整体心功能的影响。方法:选取孕28~41+6周胎儿205例(正常组120例,妊娠期糖尿病组85例),足月产1~7天新生儿90例(正常组30例,血糖控制良好组30例,血糖控制不良组30例),足月产2~3个月婴儿75例(正常组30例,血糖控制良好组25例,血糖控制不良组20例)。测量左、右心室Tei指数。结果:与正常妊娠组(左室:0.41±0.17、右室:0.41±0.16)比较,血糖控制良好组胎儿的心室Tei指数(左室:0.44±0.12,右室:0.44±0.11)无差异(P0.05),血糖控制不良组(左室:0.50±0.17,右室:0.50±0.10)均增高(P0.05)。与正常新生儿组(左室:0.40±0.14,右室:0.26±0.11)比较,血糖控制良好组(左室:0.43±0.13,右室:0.28±0.14)无差异(P0.05),血糖控制不良组(左室:0.46±0.16,右室:0.31±0.12)均增高(P0.05)。与正常婴儿组(左室:0.39±0.13,右室:0.25±0.14)比较,血糖控制良好组(左室:0.40±0.12,右室:0.25±0.17)无差异(P0.05),血糖控制不良组(左室:0.43±0.16,右室:0.29±0.12)稍高,差异有统计学意义(P0.05)。结论:GDM血糖控制不良胎儿心功能受损,新生儿、婴儿心功能仍低于正常水平。

The influence of maternal hyperglycemia on cardiac function of fetuses,newborns and infants by the application of Tei index

Objective:To study the influence of maternal hyperglycemia on cardiac function of fetuses,newborns and infants by the application of Tei index. Methods:Pregrancy 28~41+6205 fetuses were divided into normal pregnancy group (120 cases) ,gestational diabe-tes group(85 cases) . 90 newborns were divided into normal group (30 cases) ,gestational dia-betes newborn group(30 cases of good glycemic control,30 cases of poor glycemic control) . 75 infants were divided into normal group (30 cases) ,gestational diabetes infant group(25 cases of good glycemic control,20 cases of poor glycemic control) . The Tei index was calculated by the formula. Results:Compared with the normal fetal group(0. 41±0. 17,0. 41±0. 16),there was no significant changes of LV and RV Tei index in good glycemic control group ( 0 . 44 ± 0 . 12 , 0. 44±0. 11)(P>0. 05). There was significant changes of LV and RV Tei index in poor glyce-mic control group(0.50±0. 17,0. 50±0. 10)(P<0. 05). Compared with the normal newborn group(0. 40±0. 14,0. 26±0. 11),there was no significant changes of LV and RV Tei index in good glycemic control group(0. 43±0. 13,0. 28±0. 14)(P>0. 05). There was significant chan-ges of LV and RV Tei index in poor glycemic control group(0. 46±0. 16,0. 31±0. 12)(P<0. 05). Compared with the normal infant group group(0. 39±0. 13,0. 25±0. 14),there was no significant changes of LV and RV Tei index in good glycemic control group(0. 40±0. 12,0. 25± 0 . 17 ) ( P>0 . 05 ) . There was significant changes of LV and RV Tei index in poor glycemic con-trol group(0. 43±0. 16,0. 29±0. 12)(P<0. 05). Conclusion:When blood glucose is controlled poorly in gestational diabetes,the fetal,newborn and infant ncardiac function is all impaired.