标题：妊娠期糖尿病孕妇妊娠中期胎儿心脏功能超声评估

      作者：万贝贝，郑瑜，鞠雪涛，赵琳辉，吴媛，夏冬琴    西安市中心医院B超室，陕西 西安 710003

      卷次： 2019年30卷13期

      【摘要】 目的 评估妊娠期糖尿病孕妇对妊娠中期胎儿心功能的影响以及血糖控制与心脏功能的关系。方法 选择2015年3月至2017年2月西安市中心医院收治的72例胎龄在24~28周单胎妊娠的妊娠期糖尿病(GDM)孕妇为研究对象(GDM组)，同时选取胎龄在24~28周单胎妊娠超声心动图正常的72例孕妇作为对照组。采用超声心动图测量两组胎儿心脏各参数。结果 GDM组在等容舒张时间[(44.7±7.1) ms vs (41.2±6.1) ms]和收缩时间[(43.1±8.1) ms vs (39.7±8.7) ms]以及心肌做功指数[(0.55±0.08) vs (0.51±0.07)]和二尖瓣E/A比值(0.61±0.05 vs 0.64±0.08)与对照组比较差异均具有统计学意义(P<0.05)。GDM组二尖瓣环平面收缩期位移明显降低[(4.5±1.2) mm vs(4.9±1.0) mm，P<0.05]，差异具有统计学意义。结论 妊娠期糖尿病孕妇的胎儿具有较高的心脏结构及功能异常的风险，超声心动图可以检测妊娠期糖尿病孕妇妊娠中期胎儿功能性心脏异常。
      【关键词】 妊娠期糖尿病；妊娠中期；胎儿；心脏功能；超声心动图
      【中图分类号】 R714.256 【文献标识码】 A 【文章编号】 1003—6350（2019）13—1719—03

Echocardiography assessment of fetal cardiac function in pregnant women with gestational diabetes mellitusduring the second trimester of pregnancy.
WAN Bei-bei, ZHENG Yu, JU Xue-tao, ZHAO Lin-hui, WU Yuan, XIADong-qin. B-Ultrasound Room, the Central Hospital of Xi'an City, Xi'an 710003, Shaanxi, CHINA
【Abstract】 Objective To assess the effect of gestational diabetes mellitus (GDM) on fetal cardiac function inthe second trimester of pregnancy, and to analyze the relationship between glycemic control and cardiac function.Methods Seventy-two GDM pregnant women with singleton pregnancy of 24-28 weeks gestational age admitted toXi'an Central Hospital from March 2015 to February 2017 were included (GDM group). Seventy-two pregnant womenwith singleton pregnancy and gestational age between 24 and 28 weeks with normal echocardiogram in the hospitalwere included as control group. The parameters of the two groups of fetal heart were measured by echocardiography.Results Functional cardiac variables in GDM group showed a statistically difference in isovolumetric relaxation, con-traction times, the myocardial performance index, and mitral E/A ratios compared with normal control group (all P<0.05): (44.7±7.1) ms vs (41.2±6.1) ms, (43.1±8.1) ms vs (39.7±8.7) ms, (0.55±0.08) vs (0.51±0.07), (0.61±0.05) mm vs(0.64±0.08) mm, respectively. Conclusion GDM puts the fetus at risk of structural and functional cardiac abnormalities.Echocardiography can be used to detect functional cardiac abnormalities during the second trimester in fetuses of GDM.
      【Key words】 Gestational diabetes mellitus; Second trimester of pregnancy; Fetuses; Cardiac function; Echocar-diography