胰岛素两种给药方式对妊娠糖尿病疗效的比较  

Therapeutic effects of two insulin delivery systems for patients of gestational diabetes mellitus

作　　者：贾晓炜[1] 栾进[2] 

机构地区：[1]解放军第309医院内分泌风湿免疫科,北京100091 [2]武警部队综合保障基地疾病预防控制中心,北京102613

出　　处：《武警医学》2017年第5期483-486,共4页Medical Journal of the Chinese People's Armed Police Force

基　　金：解放军第309医院面上资助项目(2013MS-001)

摘　　要：目的比较胰岛素泵与直接皮下注射胰岛素对妊娠糖尿病患者(gestational diabetes mellitus,GDM)疗效。方法选择妊娠糖尿病162例,分为胰岛素泵组与皮下注射胰岛素组(注射胰岛素组)。利用动态血糖监测系统(continuous glucose monito-ring system,CGMS)观察两组血糖、胰岛功能、血脂和生存质量分数,并对获得的数据进行统计分析。结果两组患者经治疗后,血糖相关指标、C肽、血脂均得到有效控制。但从两组对比可以看出,在C肽、HbA_1c(%)、空腹血糖(FPG)、餐后2h血糖(2h PG)、平均血糖波动幅度(mean amplitude of glycemic excursions,MAGE)、日间血糖平均绝对差(mean of daily differences,MODD)这些指标上,胰岛素泵组与注射胰岛素组比较,差异有统计学意义(P<0.05),且胰岛素泵组各指标的相对偏差都较注射胰岛素组小。在对血糖漂移率和低血糖发生率控制上,胰岛素泵组治疗效果明显好于注射胰岛素组(P<0.05),但是胰岛素泵组对高血糖率的控制更好。治疗后两组患者的生存质量比较,胰岛素泵组优于注射胰岛素组(P<0.05)。胰岛素泵组对患者的躯体健康和精神健康改善明显。结论与皮下注射胰岛素相比,胰岛素泵的疗效更好,且可使GDM患者血糖维持在比较理想的水平,减少对母婴的近期及远期危害。Objective To study the difference of therapeutic effects between the insulin pump and direct injection of insulin when used for patients with gestational diabetes mellitus （GDM）. Methods 162 patients of gestational diabetes mellitus （GDM） were selected as subjects who were divided into the insulin pump group and the direct injection of insulin group, respectively. The related indicators were monitored by the continuous blood sugar monitoring system and other testing methods when the patients were treated with different therapeutic schemes. The experimental data was analyzed by SPSS 17.0 software. Results After treatment, most indicators of blood glucose, blood lipid and peptide-C in GDM patients were significantly reduced （P 〈 0.05）. Moreover, such indicators as pep- tide-C, HbA1 c （%）, FPG,2hPG, MAGE and MODD of the insulin pump group were significant lower than those in the direct injec- tion of insulin group after treatment（ P 〈 0.05 ）. The relative deviation of indicators was less in the insulin pump group than in the di- rect injection of insulin group. The insulin pump group had less glycemia variability, but a significantly higher score of quality of life than the direct injection of insulin group （ P 〈 0.05 ）. Conclusions The insulin pump has a better therapeutic effect for GDM patients than direct injection of insulin while helping to maintain an ideal level of blood glucose.

关 键 词：妊娠糖尿病 血糖 血糖波动 动态血糖监测系统 胰岛素泵 生存质量分数 

分 类 号：R587.1[医药卫生—内分泌]