两种胰岛素治疗方案治疗妊娠期糖尿病的临床疗效及患者依从性比较  

Comparison of the clinical efficacy and patients compliance of two kinds of insulin therapy for gestational dia-betes mellitus

作　　者：段成[1] 

机构地区：[1]淮南市第一人民医院内分泌科,安徽省淮南232007

出　　处：《中国基层医药》2014年第15期2263-2265,共3页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的：比较精蛋白生物合成人胰岛素预混30 R（诺和灵30 R）与生物合成人胰岛素（诺和灵R）联合精蛋白生物合成人胰岛素（诺和灵N）治疗妊娠期糖尿病的疗效及患者的依从性。方法将40例妊娠期糖尿病患者，按照随机数字表法将患者随机分为A组（20例）和B组（20例），A组患者采用诺和灵30 R治疗，B组诺和灵R联合诺和灵N治疗。比较两组患者治疗前后的血糖值及达标率和住院期间低血糖发生率，评价两种方案的的疗效、安全性；并评估两组胰岛素注射的方便性、患者的依从性。结果治疗后A组血糖达标率为70．00％（14/20），B组75．00％（15/20），差异无统计学意义（χ2＝0．125，P＞0．05）。 A组低血糖发生率10．00％（2/20）；B组5．00％（1/20），差异无统计学意义（χ2＝0．360，P＞0．05）；两组治疗后空腹血糖、餐后2 h血糖均较治疗前明显下降（t＝5．883、5．248、6．856、7．549，均P＜0．05），但两组治疗后差异均无统计学意义[（4．9±1．0）mmol/L比（4．8±1．2）mmol/L，（6．6±1．6）mmol/L比（6．3±1．8）mmol/L，t＝0．085、0．553，均P＞0．05]；A组患者不按时注射胰岛素发生率1．23％（4/324），明显低于B组的3．58％（23/642）（χ2＝4．37，P＜0．05）。结论诺和灵30 R方案与诺和灵R联合诺和灵N方案均可有效控制妊娠期糖尿病患者血糖，临床效果理想且较为安全，但前者更易被患者接受。Objective To compare the efficacy of isophane protamine biosynthetic human insulin premixed 30R（ Novolin 30R） and biosynthetic human insulin （ Novolin R） combined with protamine biosynthetic human insulin （Novolin N） in the treatment of gestational diabetes mellitus and the patients compliance .Methods According to the digital table ,40 patients with gestational diabetes mellitus were randomly divided into A group （ 20 cases ） and B group（20 cases）.A group was treated with Novolin 30R,while B group was given Novolin R combined with Novolin N.The blood glucose levels,the incidence of hypoglycemia during hospitalization ,clinical efficacy,security,conven-ience of insulin injection and compliance were compared and evaluated in the two groups .Results In A group after treatment,the compliance rate was 70.00%（14/20）,that in B group was 75.00%（15/20）,there was no significant difference（χ2 =0.125,P〉0.05）.In A group,the incidence rate of hypoglycemia was 10.00%（2/20）,that in B group was 5.00%（1/20）,there was no significant difference （χ2 =0.360,P〉0.05）.After treatment,the fasting blood glucose,postprandial 2 hours blood glucose levels in the two group were decreased significantly （ t =5.883, 5.248,6.856,7.549,all P〈0.05）,but the differences were not statistically significant between the two groups after treatment [（4.9 ±1.0）mmol/L vs.（4.8 ±1.2）mmol/L,（6.6 ±1.6）mmol/L vs.（6.3 ±1.8）mmol/L,t=0.085, 0.553,all P〉0.05].In A group,the incidence rate of irregularly injected insulin was 1.23%（4/324）,which was significantly lower than 3.58%（23/642） in B group（χ2 =4.37,P〈0.05）.Conclusion Novolin 30R program and Novolin R combined with Novolin N program can effectively control the glucose of gestational diabetes ,the clinical re-sults are satisfactory and relatively safe ,but the former is more acceptive by the patients .

关 键 词：糖尿病 妊娠 胰岛素 治疗学 

分 类 号：R714.256[医药卫生—妇产科学]