摘要
目的:应用多模态超声心动图对妊娠期糖尿病(GDM)患者心脏功能变化情况进行全面评价。方法:选取2021年9月—2023年12月我院诊断为GDM孕妇30例为GDM组,同时选取30例健康孕妇为对照组。应用常规超声心动图及二维斑点追踪成像检查获取左心室心内膜下心肌纵向峰值应变(Endo-GLS)、左心室中层心肌纵向峰值应变(Mid-GLS)、左心室心外膜下心肌纵向峰值应变(Epi-GLS)、左心室整体纵向峰值应变(Global-GLS)、左心室心内膜下心肌圆周峰值应变(Endo-GCS)、左心室中层心肌圆周峰值应变(Mid-GCS)、左心室心外膜下心肌圆周峰值应变(Epi-GCS)、左心室整体圆周峰值应变(Global-GCS)及组织运动二尖瓣环位移(TMAD)。比较上述两组参数的差异。结果:与对照组相比,GDM组孕妇Epi-GLS、Mid-GLS、Endo-GLS、Global-GLS、Epi-GCS、Mid-GCS、Endo-GCS及TMAD均减低(P<0.05);产后GDM组产妇A、E/A、Epi-GLS、Mid-GLS、Endo-GLS、Global-GLS、Epi-GCS、Mid-GCS、Endo-GCS、Global-GCS、TMAD均减低(P<0.05)。GDM组产前与产后组内比较,心率、E、A、E/e’产后均减低(P<0.05);e’、Epi-GLS、Mid-GLS、Endo-GLS、Global-GLS、Epi-GCS、Mid-GCS、Endo-GCS、Global-GCS及TMAD产后均增高(P<0.05)。结论:本研究表明,妊娠期患有GDM的妇女心脏收缩及舒张功能在产前均有轻度受损。在产后,产前轻度受损的心脏功能在一定程度上得到了恢复。左心室分层应变及TMAD可以早期发现GDM孕妇收缩功能变化。应用多模态超声心动图可以早期全面准确的评价GDM孕妇心脏功能的变化。
Objective:To evaluate the changes of prenatal and postnatal heart function in patients with gestational diabetes mellitus(GDM)by multimodal echocardiography.Methods:Thirty pregnant women diagnosed with GDM in our hospital from September 2021 to December 2023 were selected as GDM group,and 30 healthy pregnant women were selected as control group.Left ventricular endocardial global longitudinal strain(Endo-GLS),mid-myocardial global longitudinal strain(Mid-GLS),epicardial global longitudinal strain(Epi-GLS),global longitudinal strain(Global-GLS),endocardial global circumferential strain(Endo-GCS),mid-myocardial global circumferential strain(Mid-GCS),epicardial global circumferential strain(Epi-GCS),global circumferential strain(Global-GCS)and global radial strain(Global-GCS)and tissue motion tracking of mitral annular displacement(TMAD)was measured by two-dimention speckle tracking imaging and cardiac Doppler color ultrasound.Results:Compared with the control group,the GDM group had significantly decreased Epi-GLS,Mid-GLS,Endo-GLS,Global-GLS,Epi-GCS,Mid-GCS,Endo-GCS and TMAD(P<0.05);Postnatally,pregnant women in the GDM group had reduced A,E/A,Epi-GLS,Mid-GLS,Endo-GLS,Global-GLS,Epi-GCS,Mid-GCS,Endo-GCS,Global-GCS,TMAD were all reduced(P<0.05);and in the prenatal and postnatal intragroup comparisons in the GDM group,heart rate,E,A,E/e’were all reduced postpartum,e’,Epi-GLS,Mid-GLS,Endo-GLS,Global-GLS,Epi-GCS,Mid-GCS,Endo-GCS,Global-GCS,TMAD were elevated postpartum(P<0.05).Conclusion:This study showed that the heart systolic and diastolic functions of women with GDM during pregnancy were slightly impaired during delivery,and the heart function that was slightly impaired before delivery was restored to a certain extent after delivery.Left ventricular strain and TMAD can sensitively detect impaired systolic function in pregnant women with GDM early.Multimodal echocardiography can be used to early evaluate the changes of heart function in pregnant women with GDM.
作者
刘畅
任卫东
LIU Chang;REN Wei-dong(Department of Ultrasound,Shengjing Hospital of China Medical University,Shenyang 110004,China)
出处
《中国临床医学影像杂志》
北大核心
2025年第4期240-244,共5页
Journal of China Clinic Medical Imaging
作者简介
刘畅(1998-),女,辽宁新民人,住院医师。E-mail:liuchang19980319@163.com;通信作者:任卫东,中国医科大学附属盛京医院超声科,110004。E-mail:renwdcmu@163.com。
