母体血糖水平对胎儿左心室舒张功能的影响及超声心动图定量分析价值

Impacts of maternal blood glucose levels on left ventricular function and the value of quantitative analysis on echocardiography

目的:探讨超声心动图应用于母体血糖水平异常的胎儿左心室结构及舒张功能检查的价值。方法:2014-07~2016-06在本院检查的健康妊娠、妊娠期糖尿病A1级和A2级孕妇各50例纳入研究,分别设定为1、2、3组。超声心动图检查各组孕妇宫内胎儿的左心室结构相关指标,比较胎儿左心室舒张功能。结果:3组的室间隔舒张末期厚度(IVSd)、左室后壁舒张末期厚度(LVPWd)、二尖瓣环内径(MVA)均明显大于1、2组(P<0.05),1、2组组间比较差异无统计学意义(P>0.05);2、3组的峰值速度比值(E/AMV)均明显小于1组(P<0.05),左室Tei指数(LV MPI)明显高于1组(P<0.05),且2、3组组间比较差异有统计学意义(P<0.05)。结论:母体的血糖水平越高对胎儿的左心室结构及其舒张功能的影响越大,超声心动图可准确地反映和评估胎儿心脏的发育情况,具有重要的临床应用价值。

Objective：To investigate the value of echocardiography in detecting the left ventricular geometry of the fetus with abnormal maternal glucose levels.Methods：The normal fetuses（n=50）,the fetuses of mothers with gestational diabetic women class A1（n=50）and class A2（n=50）admitted to hospital from July 2014 to June 2016 were included in the study,and were set to the group one,the group two and the group three.Echocardiographic examination of the fetal heart structure and heart function level of different maternal blood glucose levels were observed and compared.Results：The levels of IVSd,LVPWd and MVA in the group three were significantly greater than those in the group one and two（P〈0.05）,but there were no significant difference between the group one and group two（P〉0.05）;the levels of E/AMV in the group two and three were significantly less than that in the group one（P〈0.05）,the LV MPI in the group two and three were significantly higher than that in the group one（P〈0.05）,and there were significant differences in the group two and three（P〈0.05）.Conclusion：The higher the maternal blood glucose level,the greater the probability of fetal heart malformations.Echocardiography can accurately reflect the development of the fetal heart.