实时三维超声心动图对妊娠期糖代谢异常的新生儿心脏的临床观察

Clinical observation of fetal heart with carbohydrate dysbolism in gestational period by real-time three-dimensional echocardiography

目的了解妊娠期糖代谢异常对新生儿心脏结构及功能的影响。方法对23例糖尿病母亲的新生儿、16例糖耐量异常母亲的新生儿及30例血糖正常母亲的新生儿于生后1周内进行实时三维超声心动图检查,观察糖尿病母亲的新生儿、糖耐量异常母亲的新生儿及血糖正常母亲的新生儿(对照组)的心脏结构及功能情况。结果糖耐量异常母亲的新生儿发生动脉导管未闭的比例较对照组高,差异有统计学意义(P<0.05),糖尿病和糖耐量异常母亲的新生儿室间隔厚度、左心室重量大于血糖正常母亲的新生儿(P<0.05),二尖瓣舒张期E峰A峰比值、三尖瓣舒张期E峰A峰比值和充盈率均较对照组减小,差异有统计学意义(P<0.01)。结论妊娠期血糖异常可对新生儿心脏造成较大影响,孕早期血糖监控对减少婴儿心脏损害有重要意义。

Objective To comprehend the influence of carbohydrate dysbolism in gestational period on function and structure of fetal heart. Methods Twenty - three neonates whose mothers with diabetes, 16 neonates whose mothers with glucose tolerance abnormality and 30 neonates whose mothers with euglycemia were examined by real - time three - dimensional echocardiography （RT- 3DE ） in one week after birth, then their heart function and structure were observed. Results The interventricular septal （IVS） thickness and the left ventricular mass （LVM） of the neonates whose mothers with diabetes and glucose tolerance abnormality were obviously thicker than those of neonates whose mothers with euglyeemia （ P 〈 0.05 ） ,and the diastolic function of left ventricular was weakened. Conehmion Pathoglycemia in gestational period may have important influence on fetal heart, and blood sugar monitoring in early gestational period has significant meaning on decreasing the incidences of heart injure.