24节段二维斑点追踪技术评估妊娠期糖尿病胎儿心室收缩功能的研究
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南京医科大学附属常州第二人民医院

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Evaluation of fetal ventricular systolic function in gestational diabetes mellitus by using 24-segment two-dimensional speckle tracking imaging technique
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    摘要:

    摘要: 目的:运用24节段二维斑点追踪(2D-STI)技术评估妊娠期糖尿病(GDM)胎儿的心室收缩功能。 方法:收集2020年5月至2021年8月间在南京医科大学附属常州第二人民医院就诊的孕晚期单胎妊娠孕妇111例,按口服葡萄糖耐量试验(OGTT)结果分为GDM组与正常对照组。所有孕妇均行胎儿超声心动图检查,获取常规胎儿超声心动图评估指标,包括左室射血分数(LVEF),左室心输出量(LVCO),面积变化分数(FAC),心脏球形指数(GSI),二尖瓣环平面收缩期位移(MAPSE),三尖瓣环平面收缩期位移(TAPSE)。同时使用24节段2D-STI技术获取胎儿心室应变指标:左室整体纵向应变(LVGLS)、左室整体圆周应变(LVGCS)、右室整体纵向应变(RVGLS)、右室游离壁应变(RVFWSt)。 结果:GDM组与正常对照组胎儿间常规超声心动图评估指标、LVGLS比较差异无统计学意义(P>0.05);GDM组胎儿LVGCS、RVGLS、RVFWSt明显低于正常对照组(P<0.05);LVGLS与LVEF、LVFAC具有正相关性(r=0.544、0.714,P<0.05),LVGCS与LVEF、LVFAC、MAPSE具有正相关性(r=0.837、0.751、0.191,P<0.05),RVGLS、RVFWSt均与RVFAC具有正相关性(r=0.517、0.421,P<0.05);孕妇体重指数(BMI)是RVGLS的独立预测因子(r2=0.311,β=0.496,95%置信区间:0.147-0.846,P<0.05)。 结论:GDM会引起胎儿心室收缩功能下降,24节段2D-STI技术可及时、准确的监测胎儿心室收缩功能,有利于临床妊娠监督。 关键词: 24节段二维斑点追踪技术;右心室应变:妊娠期糖尿病;胎儿超声心动图

    Abstract:

    Abstract: Objective: To evaluate the ventricular systolic function of fetuses with gestational diabetes mellitus (GDM) by using 24-segment two-dimensional speckle tracking imaging (2D-STI) technique. Methods: A total of 111 singleton pregnant women in Changzhou second people's Hospital affiliated to Nanjing Medical University from May 2020 to August 2021 were collected and divided into GDM group and normal control group according to the results of oral glucose tolerance test (OGTT). All pregnant women underwent fetal echocardiography to obtain routine fetal echocardiographic evaluation indexes, including left ventricular ejection fraction (LVEF), left ventricular cardiac output (LVCO), area change fraction (FAC), cardiac globular sphericity index (GSI), mitral annulus plane systolic displacement (MAPSE), tricuspid annulus plane systolic displacement (TAPSE). At the same time, 24-segment 2D-STI technique was used to obtain fetal ventricular strain indexes: left ventricular global longitudinal strain (LVGLS), left ventricular global circumferential strain (LVGCS), right ventricular global longitudinal strain (RVGLS), right ventricular free wall strain (RVFWSt). Results: There was no significant difference in traditional echocardiographic evaluation indexes and LVGLS between the GDM group and the normal control group, but the fetal LVGCS, RVGLS and RVFWSt in the GDM group were significantly lower than those in the normal control group (P<0.05). There were positive correlations between LVGLS and LVEF, LVFAC (r=0.544,0.714,P<0.05), between LVGCS and LVEF, LVFAC,MAPSE (r=0.837,0.751,0.191,P<0.05), and between RVGLS, RVFWSt and RVFAC (r=0.517,0.421,P<0.05). Maternal body mass index (BMI) was an independent predictor of RVGLS (β=0.496,95% confidence interval: 0.147-0.846,P<0.05). Conclusion: GDM can cause the decrease of fetal ventricular systolic function. 24-segment 2D-STI technique can monitor fetal ventricular systolic function timely and accurately, which is beneficial to clinical pregnancy monitoring. Key words: 24-segment two-dimensional speckle tracking technique; right ventricular strain: gestational diabetes mellitus; fetal echocardiography

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  • 收稿日期:2021-06-28
  • 最后修改日期:2021-12-30
  • 录用日期:2022-05-19
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