地特胰岛素联合门冬胰岛素对GDM患者血糖控制及妊娠结局的影响  

作　　者：徐丽娟 纪毅梅[1] 周艳茹 王芸 郑新燕[1] 

机构地区：[1]浙江省衢州市人民医院,324000

出　　处：《浙江临床医学》2020年第4期504-506,共3页Zhejiang Clinical Medical Journal

基　　金：浙江省衢州市科技计划指导性项目(2019058).

摘　　要：目的探讨地特胰岛素联合门冬胰岛素治疗妊娠期糖尿病(GDM)患者的效果及对妊娠结局的影响.方法选取2018年11月至2019年11月收治的100例GDM患者为观察对象,随机分为观察组和对照组,两组均予以饮食及运动控制后血糖仍未达标,对照组予以门冬胰岛素+鱼精蛋白锌胰岛素治疗,观察组予以门冬胰岛素+地特胰岛素治疗,两组均治疗至血糖全部达标,并维持血糖直至分娩停药,比较两组血糖达标时间、空腹血糖(FPG)、餐后2h血糖(2hPG)、糖化血红蛋白(HbA1c)、空腹胰岛素(FINS)、胰岛抵抗指数(HOMA-IR)、胰岛功能指数(HOMA-β)、脂联素、瘦素水平,随访至分娩结束,比较两组妊娠结局.结果观察组血糖达标时间为(7.38±2.86)d,显著短于对照组(12.96±2.01)d,(P<0.05);治疗后,观察组FPG、2hPG、HbA1c显著低于对照组(P<0.05);观察组HOMA-β、脂联素显著高于对照组(P<0.05),HOMA-IR、瘦素显著低于对照组(P<0.05);两组妊娠结局比较无显著差异(P>0.05).结论地特胰岛素联合门冬胰岛素治疗GDM能够有效控制血糖水平,改善胰岛素抵抗及胰岛细胞分泌功能,可能与调节脂联素、瘦素机制相关.Objective To explore the efficacy of insulin detemir combined with insulin aspart on blood glucose control of patients with GDM and its influence on the pregnancy outcome.Methods 100 patients with GDM were selected in our hospital from November 2018 to November 2019 as subjects of the study,and divided them into the observation group and the control group.The control group was treated with insulin aspart+protamine zinc insulin,and the observation group was treated with insulin aspart+insulin detemir,the treatment for both groups lasted till the blood glucose of them satisfied the standard and maintained until delivery.Compared the time of blood glucose reaching the standard,FPG,2hPG,HbA1c,FINS,HOMA-IR,HOMA-β,adiponectin and leptin between the two groups.Performed follow-up till the end of delivery,and then compared the pregnancy outcomes of both groups.Results The time of blood glucose reaching the standard in the observation group was(7.38±2.86)d,which was significantly shorter than that in the control group(12.96±2.01)d(P<0.05);after treatment,the FPG,2hPG and HbA1c in the observation group were significantly lower than those in the control group(P<0.05);the HOMA-β and adiponectin in the observation group were significantly higher than those in the control group(P<0.05),the HOMA-IR and leptin in the observation group were significantly lower than those in the control group(P<0.05);there was no significant difference in the pregnancy outcome between the two groups(P>0.05).Conclusion The insulin detemir combined with the insulin aspart can effectively control the level of blood glucose of patients with GDM,which also can improve the functions of insulin resistance and the islet cells secretion.It may be related to the mechanism of regulating adiponectin and leptin.

关 键 词：地特胰岛素 门冬胰岛素 妊娠期糖尿病 

分 类 号：R58[医药卫生—内分泌]