摘要
目的研究糖尿病孕妇胎儿的心功能变化。方法应用多普勒超声心动图测定23例妊娠期糖尿病孕妇胎儿(糖尿病孕妇胎儿组)和54例正常胎儿(正常胎儿组)心脏的解剖数值:室间隔厚度(IVS)、主动脉(AO)、肺动脉(PA)、二尖瓣(MV)、三尖瓣(TV)的直径,并测定主、肺动脉血流的峰速(PFV)、平均速度(V)、加速时间(ACT)、每搏输出量(SV)、心输出量(CO)、心脏收缩功能参数(ForceF)。测定二、三尖瓣血流舒张早期峰值流速(PFVe)、舒张晚期峰值流速(PFVa)、平均速度(V)、表示舒张功能的参数。结果糖尿病孕妇胎儿组与正常胎儿组相比,IVS明显增厚,AO、PA、MV、TV直径均增大。主、肺动脉血流的PFV、SV、ForceF均增加,ACT无明显变化。二、三尖瓣的PFVa明显增加、二、三尖瓣血流舒张早期峰值流速及舒张晚期峰值流速比值(E/A)明显下降。结论糖尿病孕妇的胎儿体重、心脏相对较大,心脏收缩力增强,心输出量增加。IVS的明显增厚使舒张功能受到影响。
Objective To assess fetal cardiac function by Doppler echocardiography in diabetic pregnancies. Methods We investigated the changes of cardiac function in 54 normal fetuses and 23 fetuses of diabetic mothers. Cardiac anatomic datas were obtained by measuring the diameter of the aortic (AO), the pulmonary artery (PA), the mitral valve(MV), the tricuspid valve (TV) and interventricular septal thickness (IVS). Blood flow evlocity were obtained from the AO, PA, atrioventricular valves. The following variables were measured: peak flow velocity (PFV), accelerate time (ACT), systolic volume (SV) and ForceF. These indices respresented the systolic function. The peak early flow velocity (PFVe), peak late flow velocity (PFVa), PFVe/PFVa(E/A), mean velocity () of MV or TV respresented the diastolic function. Results The results revealed that in fetuses of diabetic mothers, IVS became thickness. The diameter of AO, PA, MV, TV were wider than that of normal fetases. The PFV, SV, ForceF of AO or PA increased significantly. There was no different in ACT between two groups. The PFVa of MV or TV increased significantly, whereas the E/A of both atrioventricular valves decreased. Conclusion It showed that the fetal hyperinsulinemia triggered by maternal hyperglycemia result in fetal weight increasing, as well as hyperplasia and hypertrophy of myocardial cells. An iacreased contractility is compatible with relatively larger size of such fetuses. The intracardiac flow volume increased secondary to the more needs of fetal development. Abnormal thickenning IVS might impair ventricular diastolic function.
出处
《中华妇产科杂志》
CAS
CSCD
北大核心
1998年第11期658-660,共3页
Chinese Journal of Obstetrics and Gynecology
关键词
糖尿病
妊娠
胎儿
超声心动图
心功能
Diabetes, gestational Fetal heart Echocardiography, doppler Heart function tests