目的:通过频谱组织多普勒成像(TDI)和M型成像来比较妊娠期糖尿病(GDM)和对照组,以证明经常受累的胎儿室间隔(IVS)可能的功能变化。
方法:共63例GDM孕妇,饮食30(A1GDM)和胰岛素治疗33(A2GDM),随机选取与病例组相匹配的健康孕妇63例作为对照组。
结果:GDM胎儿的IVS明显增厚,早期舒张期(E')增加,心房收缩(A'),收缩期(S\'),较高的心肌性能指标(MPI),等体积弛豫时间延长(IVRT),缩短喷射时间(ET\'),与对照组相比,间隔环平面收缩期偏移(SAPSE)减少。A2GDM组胎儿IVS明显增厚,比A1GDM组增加S'和缩短ET'。在GDM组中,我们发现糖化血红蛋白水平、孕妇空腹血糖和餐后一小时血糖与胎儿IVS厚度呈显著正相关.我们证明了母体血清餐后一小时葡萄糖之间的显着负相关。糖化血红蛋白水平,和妊娠体重增加与胎儿IVSET'。
结论:与对照组相比,GDM组的胎儿IVS舒张和收缩功能发生了改变,与A1GDM相比,A2GDM的收缩功能发生了改变。这可能会提醒临床医生在产后生活中可能发生的心血管疾病,早期预防策略和长期生活方式的改变可能为GDM胎儿提供保护。
OBJECTIVE: To demonstrate possible functional changes in the frequently affected fetal interventricular septum (IVS) with spectral tissue Doppler imaging (TDI) and M-mode imaging to compare gestational diabetes mellitus (GDM) and control groups.
METHODS: A total of 63 pregnant women with GDM, 30 on diet (A1 GDM) and 33 on treated with insulin (A2 GDM), and 63 healthy pregnant women randomly selected and matched to the
case group in the control group were included.
RESULTS: The GDM fetuses had significantly thickened IVS, increased early diastole (E\'), atrial contraction (A\'), systole (S\'), higher myocardial performance index (MPI\'), prolonged isovolumetric relaxation time (IVRT\'), shortened ejection time (ET\'), and decreased septal annular plane systolic excursion (SAPSE) than the controls. The A2 GDM group fetuses had significantly thickened IVS, increased S\' and shortened ET\' than the A1 GDM group. In the GDM group, we found a significantly positive low correlation between glycated hemoglobin levels and maternal serum fasting glucose and one-hour postprandial glucose with fetal IVS thickness. We demonstrated a significantly negative low correlation between maternal serum one-hour postprandial glucose, glycated hemoglobin levels, and gestational weight gain with fetal IVS ET\'.
CONCLUSIONS: Fetal IVS diastolic and systolic functions were altered in the GDM group compared to controls, and systolic functions were altered in A2 GDM compared to A1 GDM. This may alert clinicians to possible cardiovascular diseases in the postnatal life, and early preventive strategies and long-term lifestyle changes may provide protection in fetuses with GDM.