Reller M D, Kaplan S
Department of Pediatrics, Oregon Health Sciences University, Portland 97201.
Am J Perinatol. 1988 Oct;5(4):353-8. doi: 10.1055/s-2007-999722.
Infants of diabetic mothers (IDMs) are at known risk for developing a hypertrophic type of cardiomyopathy. The severity of IDM cardiomyopathy can vary from an incidental finding on echocardiography to an infant with severe symptoms of congestive heart failure. The purpose of this article is to review the pathophysiologic mechanisms involved in the development of cardiomyopathy in IDMs and to discuss the diagnostic tests utilized in making the diagnosis (especially echocardiography) and the potential mechanisms that may result in congestive heart failure. This report will conclude with a review of a 2 1/2 year prospective study of diabetic women who had carefully maintained diabetic control during pregnancy. Although the IDMs in this study continued to have mild evidence of generalized hypertrophy when compared with control newborn infants, none developed symptoms of congestive heart failure. These data support the contention that careful diabetic management in pregnancy reduces the severity of hypertrophic cardiomyopathy in IDMs.
患有糖尿病的母亲所生婴儿(IDMs)患肥厚型心肌病的风险已知。IDM心肌病的严重程度差异很大,从超声心动图偶然发现到有严重充血性心力衰竭症状的婴儿不等。本文的目的是回顾IDMs心肌病发生发展过程中涉及的病理生理机制,讨论用于诊断的检查方法(尤其是超声心动图)以及可能导致充血性心力衰竭的潜在机制。本报告将以一项对孕期严格控制糖尿病的糖尿病女性进行的2年半前瞻性研究的综述作为结尾。尽管与对照新生儿相比,本研究中的IDMs仍有轻度的全身性肥厚迹象,但无一例出现充血性心力衰竭症状。这些数据支持了孕期对糖尿病进行精心管理可降低IDMs肥厚型心肌病严重程度这一论点。