超声心动图Tei指数评价妊娠期糖尿病孕妇胎儿心脏功能的价值.pdf

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1、山东医药2017年第57卷第1期超声心动图Tei指数评价妊娠期糖尿病孕妇胎儿心脏功能的价值阚全娥，鲁平，鲁豫，于璐，李全忠(河南省人民医院，郑州450003)摘要:目的探讨妊娠期糖尿病(GDM)孕妇胎儿心脏功能的变化及超声心动图Tei指数对胎儿心脏功能的评价作用。方法选取GDM孕妇108例，根据血糖控制情况分为血糖控制理想56例(GDM1组)和血糖控制不良52例(GDM2组);选取年龄、孕周及BMI相匹配的正常妊娠孕妇50例作为对照组。测量三组空腹血糖(FPG)、餐后2h血糖(2hPG)及糖化血红蛋白(GHbA1c)。应用多普勒超声心动图测定三组胎儿心脏结构、功能

2、指标及左、右心室的Tei指数。结果GDM2组FPG、2hPG及GHbA1c均高于GDM1组和对照组(P均＜0．05)。GDM2组胎儿左室壁厚度、右室壁厚度、右室舒张末期内径(ＲVDd)、左室短轴缩短率(LVFS)、右室短轴缩短率及左室射血分数(LVEF)均高于对照组(P均＜0．05)，GDM2组的ＲVDd、右室收缩末期内径、LVFS及LVEF均高于GDM1组(P均＜0．05)，GDM1组LVFS高于对照组(P＜0．05)。GDM1及GDM2组胎儿左、右心室Tei指数均高于对照组(P均＜0．05)，GDM2组胎儿左、右心室Tei指数高于GDM1组和对照组(P均＜0．

3、05)。结论Tei指数与GDM孕妇胎儿心脏功能变化相关，可作为临床综合评估GDM胎儿心肌受累的一项简单可靠指标。关键词:妊娠期糖尿病;超声心动图;Tei指数;血糖控制;胎儿心脏功能doi:10．3969/j．issn．1002-266X．2017．01．003中图分类号:Ｒ587．1文献标志码:A文章编号:1002-266X(2017)01-0007-04ValueofechocardiographicTeiindexinevaluatingfetalcardiacfunctionofpregnantwomenwithgestationaldiabetesmell

4、itusKANQuan'e，LUPing，LUYu，YULu，LIQuanzhong(HenanProvincialPeople＇sHospital，Zhengzhou450003，China)Abstract:ObjectiveToinvestigatethechangesoffetalcardiacfunctionandthefunctionofechocardiographicTeiindexinevaluationoffetalcardiacfunctionofpregnantwomenwithgestationaldiabetesmellitus(GDM

5、)．MethodsTo-tally108casesofpregnantwomenwithGDMweredividedintothewell-controlledgroup(GDM1group，56cases)andpoorly-controlledgroup(GDM2group，52cases)accordingtotheirbloodglucoselevels．Meanwhile，weselected50casesofage，gestationalageandBMI-matchednormalpregnantwomenasthecontrols(controlg

6、roup)．Thefastingplasmaglu-cose(FPG)，postprandialglucose(2hPG)andglycosylatedhemoglobin(HbA1c)weremeasuredinthesethreegroups．Thefetalcardiacstructure，leftandrightventricularTeiindexesineachgroupweremeasuredbyDopplerechocardio-graphy．ＲesultsFPG，2hPGandHbA1coftheGDM2groupwerehigherthanth

7、oseoftheGDM1groupandcontrolgroup(allP＜0．05)．Thefetalleftventricularwallthickness(LVWT)，rightventricularwallthickness(ＲVWT)，rightven-tricularend-diastolicdiameter(ＲVDd)，leftventricularfractionalshortening(LVFS)，rightventricularfractionalshorten-ing(ＲVFS)andleftventricularejectionfracti

8、on(LV