超声心动图多参数分析妊娠期糖尿病胎儿心功能变化的研究
摘要
目的分析胎儿超声心动图多参数评价妊娠期糖尿病胎儿心功能变化的临床意义。方法选取于该院产检的200例妊娠期糖尿病孕妇作为研究对象,分为研究1组(A1级,133例)和研究2组(A2级,67例),再选取同期的健康孕妇100例作为对照组,对胎儿进行超声心动图检查,分析比较各组胎儿的心脏各瓣环内径、心脏结构及功能参数、心肌工作指数的差异。结果研究2组的心脏各瓣环内径、心室内径、室壁厚度、心功能参数、心肌工作指数均大于研究1组和对照组,研究1组的心功能参数、心肌工作指数大于对照组,研究1组和研究2组的二、三尖瓣舒张期E、A峰值速度比值(E/AMV、E/ATV)均小于对照组(P<0.05)。结论妊娠期糖尿病孕妇血糖水平越高,胎儿心脏功能改变越明显,超声心动图的多个参数能够反映胎儿心脏功能情况。
引文
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[13]SONESSON S E,ELIASSON H,CONNER P,et al.Doppler echocardiographic isovolumetric time intervals indiagnosis of fetal blocked atrial bigeminy and 2:1atrioventricular block[J].Ultrasound Obstet Gynecol,2014,44(2):171-175.
[2]SCHNEIDER S,HOEFT B,FREERKSEN N,et al.Neonatal complications and risk factors among women with gestational diabetes mellitus[J].Acta Obstet Gynecol Scand,2011,90(3):231-237.
[3]LEE J,OUH Y T,AHN K H,et al.Preeclampsia:a risk factor for gestational diabetes mellitus in subsequent pregnancy[J].PLoS One,2017,12(5):e0178150.
[4]MPONDO B C,ERNEST A,HE D.Gestational diabetes mellitus:challenges in diagnosis and management[J].J Diabetes Metab Disord,2015,14(1):42-47.
[5]OLIVEIRA A P,CALDERON I M,COSTA R A,et al.Assessment of structural cardiac abnormalities and diastolic function in women with gestational diabetes mellitus[J].Diab Vasc Dis Res,2015,12(3):175-180.
[6]APPIAH D,SCHREINER P J,GUNDERSON E P,et al.Association of gestational diabetes mellitus with left ventricular structure and function:the CARDIA study[J].Diabetes Care,2016,39(3):400-407.
[7]张国军.妊娠期糖尿病研究进展[J].河北医科大学学报,2015,36(7):862-866.
[8]SOBREVIA L,SALSOSO R,SAEZ T,et al.Insulin therapy and fetoplacental vascular function in gestational diabetes mellitus[J].Exp Physiol,2015,100(3):231-238.
[9]PALMIERI C R,SIMOES M,SILVA J C,et al.Prevalence of hypertrophic cardiomyopathy in fetuses of mothers with gestational diabetes before initiating treatment[J].Rev Bras Ginecol Obstet,2017,39(1):9-13.
[10]KAMANA K C,SHAKYA S,ZHANG H.Gestational diabetes mellitus and macrosomia:a literature review[J].Ann Nutr Meta,2015,66(2):14-20.
[11]刘荣玮,任苓,叶军,等.产前超声心动图诊断中孕期胎儿肺动脉闭锁肺血供来源的应用[J].中国超声医学杂志,2017,33(1):90-92.
[12]GARG S,SHARMA P,SHARMA D,et al.Use of fetal echocardiography for characterization of fetal cardiac structure in women with normal pregnancies and gestational diabetes mellitus[J].J Ultrasound Med,2014,33(8):1365-1369.
[13]SONESSON S E,ELIASSON H,CONNER P,et al.Doppler echocardiographic isovolumetric time intervals indiagnosis of fetal blocked atrial bigeminy and 2:1atrioventricular block[J].Ultrasound Obstet Gynecol,2014,44(2):171-175.