组织多普勒对高原地区妊娠期糖尿病胎儿心脏功能评估的应用价值

Application value of tissue Doppler for diagnosing fetal heart function in pregnant women with gestational diabetes mellitus in plateau section

目的:探讨组织多普勒对高原地区糖尿病孕妇胎儿心功能的评估价值。方法:来自高海拔地区的50例糖尿病孕妇(糖尿病组)和非糖尿病孕妇80例(对照组),年龄及孕周均匹配,采用组织多普勒测量孕妇胎儿二、三尖瓣环处心肌运动速度(Ea,Aa,Sa峰)及Tei指数,分析胎儿左、右心室的心肌舒张及收缩功能。结果:两组孕妇胎儿三尖瓣环的运动速度Ea、Aa、Sa指标均大于相应二尖瓣环(P<0.05);不同孕周胎儿心脏二、三尖瓣环运动速度Ea、Aa值存在差异(P<0.01),Sa值无差异(P>0.05);糖尿病组胎儿心脏二、三尖瓣环Ea、Aa、Sa值均小于对照组,心肌综合指数高于对照组(P<0.05)。结论:妊娠糖尿病孕妇胎儿左、右心室心肌收缩及舒张功能可能受损,组织多普勒对评估胎儿心功能方面具有较好应用价值。

Objective:To evaluate the value of tissue Doppler for diagnosing fetal heart function of pregnant women with gestational diabetes mellitus(GDM)in plateau section.Methods:50 pregnant women with GDM from plateau section were selected in study group,and 80 normal pregnant women with the same age and gestational weeks were selected in control group.The myocardial movement velocity(Ea,Aa,Sa peak)and Tei index of the second and tricuspid annulus of fetus were measured by tissue Doppler,and the diastolic and systolic functions of left and right ventricle of fetus were analyzed.Results:The values of movement velocity Ea,Aa,and Sa of tricuspid annulus of fetus was significant higher than that of mitral annular of fetus in both groups(P<0.05).The values of movement velocity Ea and Aa of tricuspid annulus and mitral annular of fetus with different gestational weeks had significant different(P<0.01),but Sa value of fetus had no significant different(P>0.05).The values of movement velocity Ea,Aa,and Sa of tricuspid annulus and mitral annular of fetus in the study group were significant lower than those of fetus in the control group,but the value of myocardium comprehensive index of fetus in the study group was significant higher(P<0.05).Conclusion:The systolic and diastolic function of left and right ventricle of fetus of pregnant women with GDM may be damaged.Tissue Doppler has good application value for evaluating heart function of fetus.