CAJ | 학술논문

目的探讨胎儿超声心动图多参数在母体糖代谢异常胎儿左室舒张功能定量评估中的价值.方法 68例母体糖代谢异常胎儿分为母体糖耐量异常(gestational impaired glucose tolerance,GIGT)组30例和妊娠期糖尿病(gestational diabetes mellitus,GDM)组38例,随机选取63例无母体糖代谢异常的胎儿作为对照组.脉冲多普勒获取胎儿肺静脉及二尖瓣口血流频谱参数,组织多普勒技术测量二尖瓣环运动峰值速度.GIGT胎儿、GDM胎儿与对照组间各参数进行统计学分析.结果 GIGT组和GDM组胎儿肺静脉搏动指数(pulsatility index,PI)值、A峰流速与对照组比较差异均有统计学意义(P＜0.05);GIGT组与GDM组比较,PI值及A峰流速差异有统计学意义(P＜0.05);二尖瓣口血流参数及二尖瓣瓣环运动参数分别进行组间比较差异均无统计学意义(P＞0.05).结论母体糖代谢异常会引起胎儿左室舒张功能改变,其受损程度与母体血糖水平相关;胎儿肺静脉PI值及A峰流速较传统参数在评价左室舒张功能方面更为敏感.
목적 탐토태인초성심동도다삼수재모체당대사이상태인좌실서장공능정량평고중적개치.방법 68례모체당대사이상태인분위모체당내량이상(gestational impaired glucose tolerance,GIGT)조30례화임신기당뇨병(gestational diabetes mellitus,GDM)조38례,수궤선취63례무모체당대사이상적태인작위대조조.맥충다보륵획취태인폐정맥급이첨판구혈류빈보삼수,조직다보륵기술측량이첨판배운동봉치속도.GIGT태인、GDM태인여대조조간각삼수진행통계학분석.결과 GIGT조화GDM조태인폐정맥박동지수(pulsatility index,PI)치、A봉류속여대조조비교차이균유통계학의의(P＜0.05);GIGT조여GDM조비교,PI치급A봉류속차이유통계학의의(P＜0.05);이첨판구혈류삼수급이첨판판배운동삼수분별진행조간비교차이균무통계학의의(P＞0.05).결론 모체당대사이상회인기태인좌실서장공능개변,기수손정도여모체혈당수평상관;태인폐정맥PI치급A봉류속교전통삼수재평개좌실서장공능방면경위민감.
Objective To explore the value of multiple fetal echocardiographic parameters in the quantitative evaluation of fetal left cardiac diastolic function with maternal glucose metabolic abnormalities.Methods Sixty-eight fetuses of maternal glucose metabolic abnormalities were divided into gestational impaired glucose tolerance (GIGT) group (30 cases) and gestational diabetes mellitus (GDM) group (38 cases),and 63 normal fetuses were included as controls.Fetal echocardiograms were performed on these fetuses for evaluation of left cardiac diastolic function using pulsed Doppler echocardiography and myocardial tissue Doppler imaging.Each of the parameters was pair wise compared among three groups.Results The pulsatility index (PI) and A peak velocity of pulmonary vein in both GIGT group and GDM group revealed significant differences compared with controls (P ＜0.05),these two indices of pulmonary vein Doppler parameters also demonstrated significant difference between GIGT group and GDM group (P ＜0.05).Other echocardiographic parameters derived from mitral inflow Doppler and mitral annular DTI did not showed significant differences among three groups (P ＞ 0.05).Conclusions Fetal left cardiac diastolic function is impaired in maternal glucose metabolic abnormalities.Fetal pulmonary veins PI and A peak velocity are more sensitive than traditional echocardiographic parameters in evaluating fetal left ventricular diastolic function.