糖尿病孕妇胎儿心脏功能的变化及其意义

The evalution of fetal cardiac function in diabetic pregnancies

目的 研究妊娠合并糖尿病及妊娠期糖尿病 (妊娠糖尿病 )孕妇胎儿心脏形态和功能的变化。方法 应用超声诊断仪测定 2 3例妊娠糖尿病孕妇妊娠的胎儿 (研究组 )和 10 8例正常孕妇妊娠的胎儿 (对照组 )的心脏室间隔厚度、心室收缩期及舒张期周长和面积、心室收缩分数 1[(心室舒张期周长 -心室收缩期周长 ) /心室舒张期周长 ]、心室收缩分数 2 [(心室舒张期面积 -心室收缩期面积 ) /心室舒张期面积 ]。并随访两组新生儿出生体重。结果 研究组室间隔厚度为 [( 6 1± 0 7)mm , x±s,下同 ]明显高于对照组 ( 4 4± 0 7)mm。研究组左心室舒张期、收缩期面积分别为 ( 3 3± 0 8)cm2 、( 2 2± 0 6)cm2 ,明显高于对照组的 ( 2 6± 0 6)cm2 、( 2 0± 0 5)cm2 。研究组右心室舒张期面积、收缩期面积分别为 ( 3 9± 0 7)cm2 、( 2 6± 0 7)cm2 ,明显高于对照组的 ( 3 5± 0 5)cm2 、( 2 4± 0 7)cm2 。研究组左心室收缩分数 1为 0 2 0± 0 0 7,明显大于对照组的 0 12± 0 0 4。研究组左心室收缩分数 2为 0 35± 0 11,明显高于对照组的 0 2 3± 0 10。研究组右心室收缩分数 1( 0 19± 0 0 5)明显高于对照组 ( 0 13± 0 11)。研究组右心室收缩分数 2 ( 0 3 3± 0 0 9)明显高于对照组 (

Objective To assess fetal cardiac hypertrophy and ventricular function in fetuses of diabetic mothers Methods Study group was consist of 23 fetuses of diabetic pregnancies Control group was consist of 108 fetuses of normal pregnancies Cardiac size was measured by ultrasound as inter ventricular septal (IVS) thickness and ventricular diastolic and systolic (VD and VS) dimensions and perimeter Cardiac function was expressed as ventricular shortening fraction 1 (VSF1) (ventricular diastolic perimeter ventricular systolic perimeter/ventricular diastolic perimeter)and ventricular shortening fraction 2 (VSF2) (ventricular diastolic dimension Ventricular systolic dimension/ventricular diastolic dimension) Fetal birth weight was recorded Results IVS of study group (6 1±0 7) mm, which was significantly thicker than IVS of control group (4 4±0 7) mm Left ventricular diastolic dimension (LVDD) and Left ventricular systolic dimension (LVSD) of study group were (3 3±0 8)cm 2 and (2 2±0 6) cm 2, which were greater than those of control group (2 6±0 6) cm 2 and (2 0±0 5) cm 2 Right ventricular diastolic dimension (RVDD) and Right ventricular systolic dimension (RVSD) of study group were (3 9±0 7) cm 2 and (2 6±0 7) cm 2, which were also greater than those of control group (3 5±0 5) cm 2 and (2 4±0 7) cm 2 Left ventricular shortening fraction 1 of left ventricular (LVSF1) of study group was 0 20±0 07, which was greater than that of control group (0 12±0 04). LVSF2 of study group was 0 35±0 11,which was greater than that of control group too (0 23±0 10). Right ventricular shortening fraction 1 of left ventricular (RVSF1) of study group was 0 19±0 05,which was greater than that of control group (0 13±0 11). RVSF2 of study group was 0 33±0 09,which was greater than that of control group (0 23±0 14). Estimated fetal birth weight of study group was (4 076±608) g, which was greater than that of control group (3 440± 377) g Conclusion These findings showed that fetal hyperinsulinemia result in fetal weight increasing, global cardiac enlarger inter ventricular septal thickness larger and revealed hypercontractillty of ventricle in fetuses of diabetas mothers