摘要
目的:采用压力-应变环(PSL)无创技术参数定量评估晚孕期孕妇不同糖代谢异常环境下左室心肌做功变化特点。方法:收集2020年10月—2021年6月77例糖耐量异常孕妇和46例健康孕妇,并根据2020年美国糖尿病学会(ADA)诊疗指南分为妊娠期糖尿病(GDM)组和糖耐量受损(IGT)组,分别为45例和32例。在孕36周以后分娩前进行母体超声心动图检查,分别留存至少3个心动周期的心尖四腔、三腔、两腔标准切面动态图像,导入工作站并分析获取左心室压力-应变曲线及其具体参数,如整体做功指数(GWI)和效率(GWE)、整体有用功(GCW)和无用功(GWW)。并通过三维全容积成像技术获取左室的质量(LVM)、质量指数(LVMI)及左室射血分数(LVEF),并将以上参数进行比较,以评估三组参数间的差异。结果:三组间对照组GLS绝对值、GWI、GCW高于IGT组,IGT组又高于GDM组;GDM组LVM、LVMI较IGT组和对照组均增高(均P<0.05)。结论:GDM组及IGT组孕妇晚孕期左室GLS、GWI、GCW均较正常孕妇下降,且在糖尿病前期较LVM、LVMI更敏感。
Objective:To explore the characteristics of left ventricular myocardial work(MW)in the third trimester of pregnant women with abnormal glucose metabolism by non-invasive parameters of pressure-strain loop(PSL).Methods:From October 2020 to June 2021,Henan Provincial People's Hospital enrolled seventy-seven pregnant women with impaired glucose tolerance and forty-six healthy pregnant women,and a 75g oral glucose tolerance test(OGTT)was conducted at 24~28 weeks of gestation.Then 77 pregnant women were divided into gestational groups of diabetes mellitus(GDM,n=45)and impaired glucose tolerance(IGT,n=32)according to the 2020 American Diabetes Association(ADA)diagnosis and treatment guidelines.Analysis of dynamic images enabled the Echo PAC workstation to calculate the parameters of the left ventricular,including global longitudinal strain(GLS),global work index(GWI),global constructive work(GCW),global wasted work(GWW)and global work efficiency(GWE).Left ventricular mass(LVM),left ventricular mass index(LVMI)and ejection fraction(LVEF)were obtained through full-volume imaging of three-dimensional.Then the divergence of all parameters was compared among each group.Results:GWI,GCW,absolute value of GLS in groups of the normal,IGT and GDM were gradually decreased,and there were significantly different among three group(P0.05);and LVM,LVMI of GDM group were increased than the other two groups(P0.05).Conclusions:The third trimester saw the GDM and IGT group from PSL exhibiting lower GWI,GCW,and absolute GLS values than the normal pregnant women,as well as being more sensitive to prediabetes than the LVM and LVMI.
作者
朱丽敏
巧丽帕古丽·买买提
叶婷
袁建军
刘婷婷
刘冰冰
朱好辉
ZHU Li-min;Qiao Li Paguli·Maimaiti;YE Ting;YUAN Jian-jun;LIU Ting-ting;LIU Bing-bing;ZHU Hao-hui(Henan Provincial People's Hospital Zhengzhou University People's Hospital,Zhengzhou 450003,China;Red Star Hospital of the 13th Division of Xinjiang Construction Corps,Hami Xinjiang 839000,China)
出处
《中国临床医学影像杂志》
CAS
CSCD
2023年第8期588-592,共5页
Journal of China Clinic Medical Imaging
基金
国家自然科学基金项目(82171963)
河南省医学科技攻关计划省部共建项目(SB201901093)
。
关键词
心室功能
左
糖尿病
妊娠
超声心动描记术
Ventricular Function,Left
Diabetes,Gestational
Echocardiography
