| 摘要: |
| ［摘要］ 目的 探讨妊娠期糖尿病（GDM）对新生儿左心室功能的影响。方法 选取2022年1月至7月钦州市妇幼保健院新生儿科收治的GDM母亲分娩的98例足月新生儿作为GDM组，根据母亲孕期血糖控制情况进一步将GDM组分为血糖控制达标组（63例）和血糖控制不达标组（35例）。选择同期收治的非GDM母亲分娩的足月新生儿383例作为对照组。比较两组新生儿血清心肌酶谱指标、室间隔厚度以及室间隔各节段（基底段室间隔、中间段室间隔、心尖段室间隔）收缩期峰值应变水平。结果 GDM组和对照组新生儿乳酸脱氢酶（LDH）、肌酸激酶(CK)、肌酸激酶同工酶MB(CK-MB)和肌钙蛋白I(cTnI)水平比较差异均无统计学意义（P>0.05）。与对照组相比，GDM组新生儿室间隔厚度增大，基底段、中间段及心尖段的室间隔应变均较低，差异有统计学意义（P<0.05）。与血糖控制达标组相比，血糖控制不达标组新生儿室间隔厚度增大，基底段、中间段及心尖段的室间隔应变均较低，差异有统计学意义（P<0.05）。结论 GDM母亲娩出新生儿的室间隔较正常足月儿厚，且存在左室心肌力学改变，血糖控制不达标者改变程度更明显。临床医师应重视GDM母亲围产期保健，帮助其控制血糖水平。 |
| 关键词: 妊娠期糖尿病 左心室功能 新生儿 围产期保健 |
| DOI：10.3969/j.issn.1674-3806.2024.03.15 |
| 分类号:R 722.19 |
| 基金项目:钦州市科学研究与技术开发计划项目（编号：201811504） |
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| An exploration of the effect of gestational diabetes mellitus on neonatal left ventricular function |
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LU Anfeng1, LIANG Meixin2, HUANG Peilu1, BI Lei1, HUANG Guosheng1, HUANG Haiyan1
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1.Department of Neonatology, Qinzhou Maternal and Child Health Care Hospital, Guangxi 535000, China; 2.Department of Ultrasound, Qinzhou Maternal and Child Health Care Hospital, Guangxi 535000, China
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| Abstract: |
| ［Abstract］ Objective To explore the effect of gestational diabetes mellitus(GDM) on neonatal left ventricular function. Methods Ninety-eight full-term neonates delivered by gestational diabetes mellitus(GDM) mothers who were admitted to the Department of Neonatology of Qinzhou Maternal and Child Health Care Hospital from January 2022 to July 2022 were selected as the GDM group. According to the blood glucose control levels of the mothers during pregnancy, the patients in the GDM group were further divided into the blood glucose control meeting standards group(63 cases) and the blood glucose control failing to meet standards group(35 cases). Three hundred and eighty-three full-term neonates delivered by mothers without GDM who were admitted to the same hospital during the same period were selected as the control group. The serum myocardial enzyme profile, septal thickness and systolic peak strain level of each ventricular septal segment(basal ventricular septum, medial ventricular septum and apical ventricular septum) were compared between the neonates in the two groups. Results There were no significant differences in neonatal lactate dehydrogenase(LDH), creatine kinase(CK), creatine kinase lsoenzyme-MB(CK-MB) and cardiac troponin I(cTnI) between the GDM group and the control group(P>0.05). Compared with those in the control group, the thickness of the neonatal ventricular septum increased, and the septal strain of basal, middle and apical segments were lower in the GDM group, and the differences were statistically significant(P<0.05). Compared with those in the blood glucose control meeting standards group, the thickness of the neonatal ventricular septum increased, and the septal strain of basal, middle and apical segments were lower than those in the blood glucose control failing to meet standards group, and the differences were statistically significant(P<0.05). Conclusion The ventricular septa of the neonates delivered by the mothers with GDM are thicker than those of the normal full-term neonates, and these neonates delivered by the GDM mothers have myocardial mechanical changes in their left ventricles, and the changes are more obvious in the neonates delivered by the GDM mothers with blood glucose control failing to meet standards. Clinicians should pay more attention to the perinatal health care of the mothers with GDM to help them control blood glucose level. |
| Key words: Gestational diabetes mellitus(GDM) Left ventricular function Neonate Perinatal health care |
