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目的:探讨超声心动图评价妊娠期糖尿病(GDM)孕妇胎儿心脏结构及功能的价值。方法:收集2014年1月至2016年12月我院住院分娩的156例GDM孕妇为GDM组,并于同期随机选取50例孕周匹配的健康妊娠孕妇为对照组,在妊娠末期采用超声心动图对两组胎儿进行检查,检查内容包括胎儿的心脏瓣环内径、心脏结构以及心脏功能。结果:GDM组孕妇胎儿的MVA、TVA、AVA、PVA均比对照组大,差异有统计学意义(P<0.05)。GDM组孕妇胎儿的IVSs、IVSd、LVWTd、LVWTs、RVWTd、RVWTs均比对照组大,差异有统计学意义(P<0.05)。GDM组孕妇胎儿的LVEF、LVFS、RVFS均比对照组大,E/AMV、E/ATV均比对照组小,差异有统计学意义(P<0.05)。GDM组孕妇胎儿左室Tei指数(LV MPI)、右室Tei指数(RV MPI)均大于对照组(P<0.05)。结论:GDM孕妇胎儿心脏结构和功能存在不同程度的改变,超声心动图能有效监测胎儿的心脏结构和功能,从而为临床早期干预和改善预后提供依据。
Objective: To evaluate the value of echocardiography in the evaluation of fetal cardiac structure and function in gestational diabetes mellitus (GDM). METHODS: A total of 156 GDM pregnant women who were hospitalized for delivery from January 2014 to December 2016 were selected as GDM group. Fifty healthy pregnant women matched for gestational age were randomly selected as the control group during the same period. Echocardiography The two groups of fetuses were examined, including the fetal heart ring diameter, heart structure and heart function. Results: The MVA, TVA, AVA and PVA of pregnant women in GDM group were significantly larger than those in control group (P <0.05). The IVSs, IVSd, LVWTd, LVWTs, RVWTd and RVWTs of fetuses in GDM group were significantly higher than those in control group (P <0.05). The LVEF, LVFS and RVFS of fetuses in GDM group were larger than those in control group, and the E / AMV and E / ATV were both smaller than those in control group (P <0.05). The left ventricular Tei index (LV MPI) and right ventricular Tei index (RV MPI) of pregnant women in GDM group were significantly higher than those in control group (P <0.05). Conclusion: The structure and function of fetal heart in pregnant women with GDM vary in varying degrees. Echocardiography can effectively monitor the fetal heart structure and function, and provide the basis for clinical early intervention and prognosis improvement.