妊娠期糖尿病胎儿心脏功能与室间隔厚度的相关性

摘要

目的：探讨妊娠期糖尿病（GDM）胎儿心脏功能的改变与室间隔厚度的关系。资料与方法以39例GDM胎儿为研究对象，按照有无室间隔肥厚分为室间隔肥厚组（MH组）和无室间隔肥厚组（NMH组）。应用超声心动图测量胎儿心脏室间隔舒张末期厚度（IVSd），左心室射血分数（LVEF），左心室短轴缩短率（LVFS），右心室短轴缩短率（RVFS），二尖瓣E、A峰值速度比值（E/AMV），三尖瓣E、A峰值速度比值（E/ATV），主动脉瓣血流峰值速度（VPAO），肺动脉瓣血流峰值速度（VPPA），左心室心肌工作指数（LV MPI）右心室心肌工作指数（RV MPI），并与对照组进行比较。结果 NMH组VPAO、VPPA、LVEF、LVFS明显高于对照组，差异有统计学意义（P<0.05）。MH组VPAO、VPPA、LVEF、LVFS、RVFS均明显高于对照组，E/AMV、E/ATV明显低于对照组，差异有统计学意义（P<0.05）。MH组LVEF、LVFS、RVFS明显高于NMH组，E/AMV、E/ATV明显低于NMH组，差异有统计学意义（P<0.05）。MH组、NMH组LV MPI、RV MPI均高于对照组，差异有统计学意义（P<0.05）。MH组LV MPI、RV MPI均高于NMH组，差异有统计学意义（P<0.05）。LVEF、LVFS、RVFS、VPAO、VPPA与IVSd呈正相关（r=0.48，0.51，0.45，0.30，0.30, P<0.05）。结论 GDM胎儿心脏功能改变可能与心脏室间隔肥厚有关。%Purpose To explore the correlation between fetal cardiac function and interventricular septal thickness in fetuses of gestational diabetes mellitus (GDM) mothers. Materials and Methods Thirty-nine GDM mothers were involved in the study and divided into group MH (fetuses of GDM mothers with interventricular septal hypertrophy) and group NMH (fetuses of GDM mothers with normal interventricular septal thickness). Ultrasonic cardiogram was performed for both groups to assess such variables as interventricular septum thickness at end diastole (IVSd), left ventricular ejection fraction (LVEF), left ventricular fraction shortening (LVFS), right ventricular fraction shortening (RVFS), the ratio of E and A of mitral flow (E/AMV), the ratio of E and A of tricuspid flow (E/ATV), peak velocity of aortic valve (VPAO), peak velocity of pulmonary valve (VPPA) and myocardial performance index (MPI). The results were further compared with those of control group. Results The VPAO, VPPA, LVEF and LVFS in group NMH were significantly higher than those in control group (P<0.05). The VPAO, VPPA, LVEF, LVFS and RVFS in group MH were significantly higher than those in control group whilst the E/AMV and E/ATV significantly lower than those in control group (P<0.05). The LVEF, LVFS and RVFS in group MH were significantly higher than those in group NMH whilst the E/AMV and E/ATV significantly lower (P<0.05). MPI in group MH was significantly higher than that in group NMH (P<0.05), whilst both were significantly higher than that in control group (P<0.05). The LVEF, LVFS, RVFS, VPAO and VPPA were positively correlated with IVSd (r=0.48, 0.51, 0.45, 0.30, 0.30;P<0.05). Conclusion Cardiac function in fetuses of GDM mothers may be associated with interventricular septal thickness.