摘要
目的 探讨超声心动图在对娠期糖尿病孕妇妊娠中期胎儿心脏功能的评估价值,以期为临床早期诊断提供参考.方法 随机抽样选取70例我院2020年8月至2022年8月就诊的妊娠期糖尿病孕妇作为研究对象,根据血糖控制情况分为A组(血糖控制理想,36例)、B组(血糖控制不理想,34例),另随机抽样选取50名同期健康体检孕妇作为对照组,入院后均行超声心动图检查,比较3组血糖指标[空腹血糖(FPG)、餐后2h血糖(2hPBG)、糖化血红蛋白(GHbA1C)]、心脏结构及功能指标[左室收缩末期内径(LVDs)、右室舒张末期内径(RVDd)、左室舒张末期内径(LVDd)、右室收缩末期内径(RVDs)、左室壁厚度(LVWT)、左室射血分数(LVEF)、右室壁厚度(RVWT)、右室短轴缩短率(RVFS)、左室短轴缩短率(LVFS)],并比较3组左右心室心肌综合(Tei)指数,分析妊娠期糖尿病孕妇血糖、左右心室Tei指数与心脏功能指标相关性.结果 FPG、2hPBG、GHbA1C水平比较:B组＞A组＞对照组(P＜0.05);与A组、对照组比较,B组RVFS、LVEF、RVDs、RVDd、LVFS、LVWT、RVWT较高(P＜0.05);左心室Tei指数、右心室Tei指数比较:B组＞A组＞对照组(P＜0.05);经相关性分析发现,FPG、左心室Tei指数、右心室Tei指数与超声心动图心功能参数RVFS、LVFS、LVEF均呈正相关(P＜0.05).结论 超声心动图可用于评估妊娠期糖尿病孕妇胎儿心功能变化,为临床早期诊断胎儿心功能异常提供参考依据,以针对性制定后续干预方案,改善预后.
Abstract
Objective To evaluate the value of echocardiography in the evaluation of fetal heart function in the second trimester of pregnant women with diabetes to provide a reference for early clinical diagnosis.Methods Sev-enty pregnant women with gestational diabetes who received medical treatment in our hospital from August 2020 to August 2022 were selected as the study objects,and divided into Group A(ideal blood glucose control,n=36)and Group B(unsatisfactory blood glucose control,n=34)according to their blood glucose control.Another 50 healthy pregnant women in the same period were selected as the control group,and echocardiography was performed after ad-mission.Blood glucose indexes[fasting blood glucose(FPG),2 h postprandial blood glucose(2hPBG),glycated hemoglobin(GHbA1C)],cardiac structure and function indexes[left ventricular end-systolic diameter(LVDs),ventric-ular end-diastolic diameter(RVDd),left ventricular end-diastolic diameter(LVDd),right ventricular end-systolic diam-eter(RVDs),and left ventricle wall thickness(LVWT),left ventricular ejection fraction(LVEF),right ventricular wall thickness(RVWT),right ventricular short axis shortening rate(RVFS),left ventricular short axis shortening rate(LVFS)],and the left and right ventricular Tei index of the three groups were compared and analyze the correlation between blood glucose,left and right ventricular Tei index and cardiac function indicators in pregnant women with gestational diabetes mellitus.Results The levels of FPG,2hPBG,and GHbA1C were compared in group B＞Group A＞control group(P＜0.05).Compared with group A and the control group,group B had higher RVFS,LVEF,RVDs,RVDd,LVFS,LVWT,and RVWT(P＜0.05).The left ventricular Tei index and right ventricular Tei index were com-pared in group B＞group A＞control group(P＜0.05).Correlation analysis showed that FPG,left ventricular Tei index,and right ventricular Tei index was positively correlated with echocardiographic cardiac function parameters RVFS,LVFS,and LVEF(P＜0.05).Conclusion Echocardiography can be used to evaluate the changes in fetal cardiac func-tion in pregnant women with gestational diabetes mellitus,and provide a reference for early clinical diagnosis of fetal cardiac function abnormalities,so as to formulate follow-up intervention plans and improve prognosis.
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