妊娠期糖尿病孕妇血清hcy联合Tei指数检测对胎儿心功能的预测价值

The predictive value of serum hcyl evel of women with gestational diabetes combined with Tei index for fetal cardiac function

目的:探讨妊娠期糖尿病(GDM)孕妇血清hcy联合心肌做功指数(Tei指数)检测对胎儿心功能的预测价值。方法:选取2017年1—12月四川省巴中市中心医院产科收治的GDM孕妇90例作为GDM组,以30例健康孕妇作为对照组。依据治疗后空腹血糖(FPG)及餐后2h血糖(2hPBG)水平,将GDM孕妇分为A组(血糖控制良好组)、B组(血糖控制不良组)。检测各组血清同型半胱氨酸(hcy)水平、心肌做功指数(Tei指数),记录新生儿体重及Apgar评分,分析血清hcy与Tei指数的相关性。结果:B组新生儿体重高于对照组(P<0.05),1min Apgar评分低于对照组(P<0.05)。入组时,A组、B组血清hcy均高于对照组(P<0.05);A组分娩当日血清hcy低于入组时(P<0.05);B组分娩当日血清hcy高于入组时(P<0.01);分娩当日,B组血清hcy高于A组(P<0.01)。B组胎儿左、右心室Tei指数均高于对照组(P<0.05)。胎儿左、右心室Tei指数与GDM孕妇血清hcy水平呈正相关关系(r左心室=0.750,r右心室=0.727,P<0.01)。结论:GDM孕妇血清hcy升高,胎儿Tei指数增高,两者呈正相关关系;GDM孕妇血清hcy联合Tei指数检测对胎儿心功能的预测具有较高的价值。

Objective： To investigate the predictive value of serum homocysteine （hcy） level of women with gestational diabetes mellitus （GDM） combined with Tei index for fetal heart function.Methods： A total of 90 GDM pregnant women were selected as group A （good blood glucose control） and group B （poor blood glucose control）.30 healthy pregnant women were selected as a control group.The serum level of hcy and Tei index were detected.The Apgar score and body weight were recorded.The correlation between the serum hcy level of GDM pregnant women and the fetal Tei index was analyzed.Results： The body weight of group B was higher than that of the control group,and the 1 min Apgar score was lower （ P 〈0.05）.The serum hcy level of GDM patients at pre-delivery was higher than that of controls （ P 〈0.05）,and it was significantly decreased in group A when delivery whereas increased in group B （ P 〈0.01）.The serum hcy level in group B was higher than that in group A on the day of delivery （ P 〈0.01）.The left ventricular Tei index and right ventricular Tei index in group B were higher than those in the control group （ P 〈0.05）.There was a positive correlation between the left and right ventricular Tei index of the fetus and the level of serum hcy in GDM pregnant women （ r left ventricular =0.750, r right ventricle =0.727, P 〈0.01）.Conclusion： The serum hcy level of GDM women increased with fetal Tei index increased.The combination of serum hcy level of GDM women and fetal Tei index was valuable for predicting fetal cardiac function.