母亲妊娠期糖尿病对新生儿左心功能的影响

Left ventricular function in newborn infants of mothers with gestational diabetes mellitus

摘要:

目的：评估妊娠期糖尿病（GDM）母亲的新生儿左心功能状况。方法：GDM母亲娩出的新生儿40例（GDM组）及正常新生儿40例（对照组）作为研究对象，应用超声二维斑点追踪成像技术检测室间隔厚度、左室后壁厚度、射血分数，并计算左室旋转和扭转参数。结果：GDM组新生儿室间隔舒张厚度（0.45±0.06 mm）较对照组（0.34±0.05 mm）增大；GDM组左室后壁舒张厚度（0.45±0.17 mm）亦较对照组（0.31±0.02 mm）增大，差异均有统计学意义（P0.05）。GDM组新生儿内膜旋转峰值、外膜旋转峰值、平面旋转峰值、跨壁扭转峰值均较对照组升高，差异有统计学意义（P<0.05）。结论：GDM母亲的新生儿左心室的形态和旋转及扭转运动发生变化，心功能虽受到损害，但处于代偿状态，能维持正常的射血功能。超声二维斑点追踪成像技术可作为早期检测新生儿左心功能的良好手段。

Abstract:

To evaluate left ventricular function in newborn infants of mothers with gestational diabetes mellitus (GDM). METHODS: Forty newborn infants of mother with GDM (GDM group) and forty normal newborn infants (control group) were enrolled in this study. Two-dimensional speckle tracking imaging was used to measure interventricular septal thickness, posterior left ventricular wall thickness and left ventricular ejection fraction in both groups. Left ventricular rotation and torsion were evaluated for all participants. RESULTS: Interventricular septal thickness in the GDM group was much higher than in the control group (0.45±0.06 mm vs 0.34±0.05 mm; P0.05). Peak subendocardial rotation, peak subepicardial rotation, peak bulk rotation and peak mural torsion were higher in the GDM group than in the control group (P<0.05). CONCLUSIONS: Cardiac function may be impaired in newborn infants of mothers with GDM, with changes in left ventricular shape and abnormalities of left ventricular rotation and torsion. However, infants have a normal ventricular blood ejection under the cardiac compensation. Two-dimensional speckle tracking imaging technique can be used for early detection of left ventricular function.