胰岛素对不同孕期GDM患者血糖水平及妊娠结局的影响  

Effect of insulin on blood glucose levels and pregnancy outcome of GDM women in different stages of pregnancy

作　　者：杨芬[1] 邱兰[1] 

机构地区：[1]武汉科技大学附属孝感市中心医院产科,湖北孝感432000

出　　处：《中国妇幼保健》2017年第12期2539-2542,共4页Maternal and Child Health Care of China

基　　金：湖北省卫生厅基金项目(JX7B31)

摘　　要：目的探讨胰岛素对不同孕期妊娠期糖尿病(GDM)患者血糖水平及妊娠结局的影响。方法选取2015年1-12月的GDM患者115例,根据孕期将患者分为孕周<32周组(32例)、孕周32~34周组(40例)和孕周≥35周组(43例)。3组患者均采用胰岛素治疗,观察各组患者血糖变化、妊娠结局及新生儿并发症发生率。结果治疗前,3组空腹血糖及餐后2 h血糖水平比较差异均无统计学意义(P>0.05);分娩前,3组空腹血糖及餐后2 h血糖水平较治疗前均明显降低(P<0.05);孕周<32周组分娩前空腹血糖和餐后2 h血糖水平明显低于其他组(P<0.05);孕周32~34周组和孕周≥35周组分娩前空腹血糖和餐后2 h血糖水平比较差异均无统计学意义(P>0.05)。3组产后出血发生率比较差异无统计学意义(P>0.05);孕周<32周组妊娠期高血压疾病发生率、剖宫产率和早产发生率明显低于其他两组,差异均有统计学意义(均P<0.05)。3组新生儿窒息、新生儿低血糖及巨大儿发生率比较差异均无统计学意义(P>0.05)。结论胰岛素治疗能有效控制GDM患者血糖水平,早期干预效果较好,且对改善妊娠结局有一定作用。Objective To explore the effect of insulin on blood glucose levels and pregnancy outcome of gestational diabetes mellitus（ GDM） women in different stages of pregnancy. Methods A total of 115 pregnant women with GDM were selected from January to December in 2015,then they were divided into 32 gestational week group（ 32 cases）,32-34 gestational week group（ 40 cases）,and ≥35 gestational week group（ 43 cases） according to gestational week. The women in the three groups were treated by insulin,then the changes of blood glucose,pregnancy outcomes and incidence rates of neonatal complications in the three groups were observed. Results Before treatment,there was no statistically significant difference in fasting blood glucose and postprandial 2-hour blood glucose among the three groups（ P〉0. 05）; before delivery,fasting blood glucose and postprandial 2-hour blood glucose in the three groups were statistically significantly lower than those before treatment（ P〈0. 05）; fasting blood glucose and postprandial 2-hour blood glucose in 32 gestational week group were statistically significantly lower than those in the other two groups（ P〈0. 05）; there was no statistically significant difference in fasting blood glucose and postprandial 2-hour blood glucose between 32-34 gestational week group and ≥35 gestational week group（ P〉0. 05）.There was no statistically significant difference in the incidence rate of postpartum hemorrhage among the three groups（ P〈0. 05）; the incidence rates of hypertensive disorder complicating pregnancy,cesarean section,and premature delivery in 32 gestational week group were statistically significantly lower than those in the other two groups（ all P〈0. 05）; there was no statistically significant difference in the incidence rates of neonatal asphyxia,neonatal hypoglycemia,and macrosomia among the three groups（ P〉0. 05. Conclusion Insulin therapy can effectively control blood glucose level of GDM patients,the early intervention effect is good,and

关 键 词：妊娠期糖尿病 胰岛素 妊娠结局 血糖 

分 类 号：R714.256[医药卫生—妇产科学]