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

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

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(P>0.05),血糖控制不良组(左室:0.50±0.17,右室:0.50±0.10)均增高(P<0.05)。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(P>0.05),血糖控制不良组(左室:0.46±0.16,右室:0.31±0.12)均增高(P<0.05)。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(P>0.05),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(P<0.05)。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。

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 diabetes group（85 cases）.90 newborns were divided into normal group（30 cases）,gestational diabetes 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）（P0.05）.There was significant changes of LV and RV Tei index in poor glycemic 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 glycemiccontrol group（0.43±0.13,0.28±0.14）（P 0.05）.There was significant changes of LV and RV Tei index in poor glycemic control group（0.46±0.16,0.31±0.12）（P0.05）.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）（P0.05）.There was significant changes of LV and RV Tei index in poor glycemic control group（0.43±0.16,0.29±0.12）（P0.05）.Conclusion：When blood glucose is controlled poorly in gestational diabetes,the fetal,newborn and infant ncardiac function is all impaired.