Objective To investigate the changes of fetal cardiac function and the function of echocardiographic Tei index in evaluation of fetal cardiac function of pregnant women with gestational diabetes mellitus (GDM).Methods To-tally 108 cases of pregnant women with GDM were divided into the well-controlled group (GDM1 group,56 cases)and poorly-controlled group (GDM2 group,52 cases)according to their blood glucose levels.Meanwhile,we selected 50 cases of age,gestational age and BMI-matched normal pregnant women as the controls (control group).The fasting plasma glu-cose (FPG),postprandial glucose (2 h PG)and glycosylated hemoglobin (HbA1c )were measured in these three groups. The fetal cardiac structure,left and right ventricular Tei indexes in each group were measured by Doppler echocardio-graphy.Results FPG,2 h PG and HbA1c of the GDM2 group were higher than those of the GDM1 group and control group (all P <0.05).The fetal left ventricular wall thickness (LVWT),right ventricular wall thickness (RVWT),right ven-tricular end-diastolic diameter (RVDd),left ventricular fractional shortening (LVFS),right ventricular fractional shorten-ing (RVFS)and left ventricular ejection fraction (LVEF)of GDM2 group were significantly higher than those of the control group (all P <0.05).The fetal RVDd,right ventricular end-systolic diameter,LVFS and LVEF of the GDM2 group were higher than those of the GDM1 group (all P <0.05).The GDM1 group's fetal LVFS was higher than that of the control group (P <0.05).The Tei index of fetal left and right ventricular of GDM2 group and GDM1 group was significantly higher than that of the control group,and the difference was statistically significant (all P <0.05).The average Tei index of fetal left and right ventricular of GDM2 group was higher than that of the GDM1 group and control group (all P <0.05).Con-clusions Tei index,which is associated with fetal cardiac function in GDMpregnant women,can be used as a simple and reliable indicator in the clinical comprehensive evaluation of fetal cardiac involvement.%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2 h 血糖（2 h PG）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、功能指标及左、右心室的 Tei 指数。结果 GDM2组 FPG、2 h PG 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＜0．05）。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。
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