超声心动图在妊娠期糖尿病胎儿心脏结构及功能评价中的应用研究

Application of echocardiography to fetal heart structure and function evaluation in gestational diabetes mellitus

目的 应用超声心动图评价妊娠期糖尿病(GDM)胎儿心脏结构及功能的变化。方法 选取30例妊娠期糖尿病患者(GDM组)和同期42例正常妊娠孕妇(对照组),应用胎儿超声心动图检查胎儿心脏,测量卵圆孔径(FOD)、左房横径、右房内径、左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)、右心室舒张末期内径(RVEDD)、右心室收缩末期内径(RVESD)、室间隔舒张末期厚度(IVSd)、左室壁厚度(LVWT)及右室壁厚度(RVWT),二尖瓣E、A峰血流速度比(MVE/A)、三尖瓣E、A峰血流速度比(TVE/A)、左心室输出量(LVCO)、右心室输出量(RVCO)、左室短轴缩短率(LVFS)、左室射血分数(LVEF),右室短轴缩短率(RVFS)。结果 GDM组胎儿IVSd、RVWT指标明显高于对照组,而FOD、MVE/A、TVE/A、RVFS低于对照组(P<0.05)。GDM组LVWT、左右房室内径、左右心输出量、左室收缩功能与对照组比较,差异无统计学意义(P>0.05)。结论 GDM可影响胎儿的心脏结构及功能,超声心动图是评价GDM胎儿心脏结构和功能的重要方法。

Objective To evaluate the changes of fetal heart structure and function in gestational diabetes mellitus (GDM) by echocardiography. Methods Thirty GDM patients (GDM group) and 42 concurrent healthy pregnant women(control group) were enrolled. Fetal echocardiography was used to examine fetal heart, and foramen ovale diameter(FOD), left atrial transverse diameter, right atrial diameter,left ventriculaRend-diastolic diameter(LVEDD),left ventriculaRend-systolic diameter(LVESD), right ventriculaRend-diastolic diameter(RVEDD), right ventriculaRend-systolic diameter(RVESD), inter-ventriculaRseptum end-diastolic thickness (IVSd),left ventriculaRwall thickness (LVWT), right ventriculaRwall thickness(RVWT), mitral valve peak velocity early diastolic filling ( E wave ) to peak velocity of late diastolic filling (A wave) ratio (MV E/A),tricuspid valve peak velocity early diastolic filling (E wave) to peak velocity of late diastolic filling (A wave) ratio ( TV E/A ), Left ventriculaRcardiac output (LVCO), right ventriculaRcardiac output (RVCO), left ventriculaRfraction shortening(LVFS), left ventriculaRejection fraction(LVEF), and right ventriculaRfraction shortening (RVFS) were measured. Results The GDM group had significantly higheRfetal IVST and RVWT as well as loweRFOD, MV E/A, TV E/A and RVFS than the control group ( P <0.05 ). There was no significant difference between the GDM group and the control group in LVWT, left oRright atrial/ventriculaRdiameter, left oRright cardiac output, oRleft ventriculaRsystolic function ( P >0.05). Conclusion GDM can affect fetal heart structure and function. Echocardiography is an important method foRevaluating fetal heart structure and function in GDM.