格列苯脲对妊娠期糖尿病孕妇血糖水平及母婴围生结局改善效果分析  

Effect of glibenclamide on blood glucose levels and perinatal outcomes of patients with gestational diabetes mellitus

作　　者：何泉江[1] 卢白玉 卢宗杰[1] 卢艺 HE Quan-jiang;LU Bai-yu;LU Zong-jie;LU Yi(Department of Obstetrics and Gynecology,Suining Central Hospital,Suining 629000,China;Suining Center for Disease Control and Prevention,Suining 629000,China)

机构地区：[1]遂宁市中心医院妇产科,四川遂宁629000 [2]遂宁市疾控中心,四川遂宁629000

出　　处：《实用药物与临床》2018年第12期1386-1389,共4页Practical Pharmacy and Clinical Remedies

摘　　要：目的探讨格列苯脲对妊娠期糖尿病(GDM)孕妇血糖水平及母婴围生结局改善的效果。方法收集2014年9月至2016年9月在我院接受治疗的GDM患者40例,按照随机数表法分为对照组、观察组,每组20例。对照组患者接受二甲双胍治疗,观察组患者接受格列苯脲治疗,两组治疗均持续至分娩前。比较两组患者治疗前后血糖指标、胰岛素抵抗指标水平,记录两组母婴围生期不良结局。结果治疗前,两组患者外周血中血糖指标、胰岛素抵抗指标水平比较差异无统计学意义(P> 0. 05)。治疗后,观察组患者外周血FBG、Hb A1c、FINS、HOMA-IR水平低于对照组(P <0. 05)。观察组先兆子痫、早产、产后出血、胎儿窘迫等母婴不良结局发生率低于对照组,巨大儿、新生儿低血糖等胎儿/新生儿不良结局发生率高于对照组(P <0. 05)。结论在GDM患者的治疗中,格列苯脲的优化血糖水平、减轻胰岛素抵抗的作用优于二甲双胍,但可增加巨大儿、新生儿低血糖等胎儿/新生儿不良结局的发生率。Objective To study the effect of glibenclamide on blood glucose levels and perinatal outcomes in patients with gestational diabetes mellitus(GDM).Methods Totally40cases of GDM patients in our hospital from September2014to September2016were randomly divided into control group(n=20)and observation group(n=20).Patients in control group were treated with metformin,and those in observation group were treated with glibenclamide,both treatments lasting until delivery.The indexes of blood glucose of insulin resistance were compared between the two groups before and after treatment,and the adverse outcomes of two groups were recorded.Results There was no significant difference in peripheral blood indexes of blood glucose or insulin resistance between the two groups before treatment(P>0.05).After treatment,the levels of FBG,HbAlc,FINS and HOMA-IR in peripheral blood of observation group were lower than those of control group(P<0.05).The rates of adverse outcomes,including pre-eclampsia,premature delivery,postpartum hemorrhage and fetal distress in observation group were lower than those in control group,while the rates of macrosomia and neonatal hypoglycemia in observation group were higher(P<0.05).Conclusion Glibenclamide can optimize the blood glucose of GDM patients,whose effects of reducing insulin resistance is better than metformin,but it may increase the incidences of macrosomia and neonatal hypoglycemia.

关 键 词：妊娠期糖尿病 格列苯脲 糖代谢 胰岛素抵抗 母婴结局 

分 类 号：R714.256[医药卫生—妇产科学]