甲钴铵联合诺和锐特充治疗妊娠糖尿病的临床疗效及对血清RBP4 FGF21 Nesfatin-1的影响  

Clinical Efficacy of Mecobalamin Combined with Norfloxacin in the treatment of Gestational Diabetes Mellitus and its Effect on Serum RBP4 FGF21 and Nesfatin-1

作　　者：樊晓君[1] 王晶[1] FAN Xiaojun;WANG Jing(Baoji City Maternal and Child Health Hospital,Shaanxi Baoji 721000,China)

机构地区：[1]陕西省宝鸡市妇幼保健院产科,陕西宝鸡721000

出　　处：《河北医学》2018年第11期1849-1853,共5页Hebei Medicine

基　　金：陕西省自然科学基金项目;(编号:20100216)

摘　　要：目的:探讨甲钴铵联合诺和锐特充治疗妊娠糖尿病的临床疗效及对血清视黄醇结合蛋白4(RBP4)、成纤维细胞生长因子21(FGF21)、摄食抑制因子-1(Nesfatin-1)的影响。方法:选择2016年10月至2017年10月我院接诊的100例妊娠期糖尿病患者作为本研究对象,通过随机数表法分为观察组(n=50)和对照组(n=50),对照组给予诺和锐特充治疗,观察组联合甲钴胺治疗,两组均以7d为1个疗程,连续治疗3个疗程。比较两组血糖、血清RBP4、FGF21、Nesfatin-1的变化和妊娠结局、治疗期间不良反应。结果:治疗后,两组空腹血糖(FPG)、餐后2h血糖(2hPBG)较治疗前均显著降低(P<0.05),观察组FBG、2hPBG均明显低于对照组(P<0.05);治疗后,两组血清RBP4、FGF21、Nesfatin-1较治疗前均显著降低(P<0.05),观察组血清RBP4、FGF21、Nesfatin-1明显比对照组低[(21.20±2.47)μg/m L VS(26.94±3.24)μg/m L,(101.39±13.52) ng/L VS(127.34±14.50) ng/L,(1.38±0.20)μg/L VS(1.67±0.27)μg/L](P<0.05);两组新生儿呼吸窘迫发生率比较无显著差异(P>0.05),观察组剖宫产、羊水过多、巨大儿、新生儿早产发生率分别为4.00%(2/50)、4.00%(2/50)、2.00%(1/50)、4.00%(2/50),明显低于对照组的18.00%(9/50)、16.00%(8/50)、14.00%(7/50)、18.00%(9/50),差异均具有统计学意义(P <0.05);治疗期间,观察组低血糖、恶心呕吐、高渗性昏迷总发生率为8.00%(4/50),明显低于对照组的24.00%(12/50)(P <0.05)。结论:在妊娠期糖尿病患者中应用甲钴胺联合诺和锐特充治疗效果显著,可有效降低血糖和血清RBP4、FGF21、Nesfatin-1的表达,改善不良母婴结局,且用药安全性高,值得应用推广。Objective： To study curative efficacy of mecobalamin combined with insulin aspart flexpen intreatment of gestational diabetes mellitus and effects on serum retinol-binding protein 4（RBP4）, fibroblastgrowth factor 21（FGF21）, feeding inhibition factor -1（Nesfatin-1） levels. Methods： 100 patients of gestational diabetes mellitus who received therapy from October 2016 to October 2017 in our hospital were selectedas research objects. According to random number table, all the patients were divided into the observation group（n = 50） and the control group （n = 50）. The control group was treated with insulin aspart flexpen, while theobservation group was combined with mecobalamin, they were treated with 7d for 1 courses, continuous treatment for 3 courses. Results： After treatment, fasting blood glucose （FPG） and 2-hour postprandial blood glucose （2-hour PBG） in both groups were significantly lower than those before treatment （P〈0.05）, FBG and2-hour PBG in observation group were significantly lower than those in control group （P〈0.05）. After treatment, the levels of RBP4, FGF21 and Nesfatin-1 in serum of the two groups were significantly lower thanthose before treatment （P〈0.05）. The levels of RBP4, FGF21 and Nesfatin-1 in the observation group weresignificantly lower than those in the control group [（21.20＋2.47） ug / mL VS （26.94＋3.24） ug / mL, （101.39＋13.52） ng / L VS （127.34＋14.50） ng / L, （1.38＋0.20） ug / L VS （1.67＋0.27）. G/ L] （P〈0.05）, The totalincidence of hypoglycemia, nausea, vomiting and hyperosmotic coma in the observation group was 8.00% （4 /50）, significantly lower than that in the control group （24.00% （12 / 50） （P〈0.05）. Conclusion： Mecobalamin combined with norfloxacin has significant therapeutic effect on gestational diabetes mellitus. It can effectively reduce blood glucose and the expression of RBP4, FGF21 and Nesfatin-1 in serum, and improve theadverse maternal and infant outcomes. It is saf

关 键 词：妊娠糖尿病 诺和锐特充 甲钴铵 血清因子 妊娠结局 

分 类 号：R714.256[医药卫生—妇产科学]