摘要
目的 观察血糖控制良好的妊娠期糖尿病（gestational diabetes mellitus,GDM）产妇的新生儿生后早期心脏血流动力学状况.方法 应用超声心输出量监测仪（ultrasonic cardiac output monitor,USCOM）测定2015年1月至4月在同济大学附属第一妇婴保健院分娩的22例血糖控制良好的GDM产妇的新生儿（GDM组）和20例正常产妇的新生儿（对照组）生后1和2h的心脏血流动力学相关指标,包括主动脉血流峰值流速、肺动脉血流峰值流速、左心室输出量、右心室输出量、心脏收缩力指数.监测2组新生儿的末梢血血糖及心率、呼吸、血压等生命体征.采用两独立样本t检验或x2检验进行统计学分析.结果 GDM组新生儿的末梢血血糖为（3.0±0.4） mmol/L,低于对照组的（4.0±0.4） mmol/L,差异有统计学意义（t=8.400,P＜0.01）,但均在正常范围内.2组新生儿心率、呼吸、血压等生命体征指标差异无统计学意义（P值均＞ 0.05）.GDM组新生儿生后1和2h的主动脉峰值流速[分别为（1.230±0.160）和（1.210±0.220） m/s]、左心室输出量[分别为（0.867±0.196）和（0.859±0.193） L/min]、心脏收缩力指数[分别为（0.846±0.180）和（0.823±0.189） W/m2]均高于对照组[分别为（1.080±0.130）和（1.090±0.120） m/s;（0.754±0.098）和（0.757±0.099） L/min;（0.746±0.097）和（0.725±0.086）W/m2,t值分别为3.464、2.265、2.296、2.187、2.263和2.202,P值均＜0.05],肺动脉峰值流速和右心输出量差异无统计学意义（P值均＞ 0.05）;同一组新生儿生后1与2h心脏血流动力学相关指标差异无统计学意义（P值均＞ 0.05）.结论 血糖控制良好的GDM产妇新生儿早期心脏左心收缩能力及做功增加.
Objective To investigate the early changes of cardiac output and vital signs in term neonates shortly after born from gestational diabetic women.Methods From January 2015 to April 2015, 22 term neonates of gestational diabetes mellitus （GDM） women with euglycemia during pregnancy （GDM group） and 20 term neonates of non complicated gravidas （control group） in Shanghai First Maternity and Infant Hospital were enrolled.Neonates in both groups were measured by ultrasonic cardiac output monitor （USCOM） for cardiac hemodynamics index, including aortic peak flow velocity, pulmonary artery peak flow velocity, left cardiac output, right cardiac output and Smith Madigan inotropy index at one and two hours after birth.Vital signs including heart rate, respiratory rate, blood pressure and peripheral blood glucose were measured as well.Two independent sample t-test and Chi square test were used for statistical analysis.Results The peripheral blood glucose of neonates in GDM group was significantly lower than that of the control [（3.0±0.4） vs （4.0± 0.4） mmol/L, t=8.400, P 〈 0.01）, but all within normal range.Vital signs including heart rate, respiratory rate, mean blood pressure showed no differences between the groups （all P 〉 0.05）.In GDM group, aortic peak flow velocity were （1.230±0.160） and （1.210±0.220） m/s, left ventricle cardiac output was （0.867±0.196） and （0.859±0.193） L/min, Smith Madigan inotropy index was （0.846±0.180） and （0.823±0.189） W/m2 at one and two hours after birth, respectively, which were significantly higher than those in the control group [aortic peak flow velocity： （1.080±0.130） and （1.090± 0.120） m/s;left ventricle cardiac output： （0.754±0.098） and （0.757 ± 0.099） L/min;Smith Madigan inotropy index： （0.746 ± 0.097） and （0.725 ± 0.086） W/m2;t=3.464, 2.265, 2.296, 2.187, 2.263 and 2.202, respectively, all P 〈 0.05].But no statistically significant differences was found on pulmonary artery peak flow
出处
《中华围产医学杂志》
CAS
CSCD
2015年第12期927-931,共5页
Chinese Journal of Perinatal Medicine
关键词
糖尿病
妊娠
婴儿
新生
血流动力学
心排血量
Diabetes,gestational
Infant,newborn
Hemodynamics
Cardiac output
