二甲双胍联合门冬胰岛素治疗妊娠期糖尿病临床评价  

Metformin Combined with Norfloxacin in the Treatment of Gestational Diabetes Mellitus

作　　者：温学娜 刘洁[2] WEN Xuena;LIU Jie(Xinji First Hospital,Xinji,Hebei,China 052360;Shijiazhuang Fourth Hospital,shijiazhuang,hebei,China 050000)

机构地区：[1]河北省辛集市第一医院,河北辛集052360 [2]河北省石家庄市第四医院,河北石家庄050000

出　　处：《中国药业》2020年第14期53-55,共3页China Pharmaceuticals

基　　金：河北省2018年度医学科学研究重点课题[20181064]。

摘　　要：目的探讨二甲双胍联合门冬胰岛素治疗妊娠期糖尿病的临床疗效及对血浆因子和胰岛素抵抗的影响。方法选取医院2017年6月至2019年6月收治的妊娠期糖尿病患者,按随机数字表法分为观察组和对照组,各48例。两组患者均予健康教育、控制饮食、增加运动训练等基础治疗,并予门冬胰岛素注射液皮下注射,观察组患者加服盐酸二甲双胍片。两组患者均连续治疗至分娩。结果治疗后,观察组患者空腹血糖(FBG)、餐后2 h血糖(2 hPG)、糖化血红蛋白(Hb A1C)水平,日内血糖平均波动幅度(MAGE)、血糖水平标准差(SDBG)、日内血糖平均绝对差(MODD),胰岛素抵抗指数(HOMA-IR)均明显低于对照组(P <0.05),而血浆胰淀素(Amylin)、脂联素(ADPN)水平均明显高于对照组(P <0.05);观察组早产、剖宫产、胎膜早破、新生儿黄疸、呼吸窘迫、新生儿窒息等不良结局发生率均明显低于对照组(P <0.05);观察组不良反应发生率为16.67%,与对照组的10.42%相当(P> 0.05)。结论二甲双胍联合门冬胰岛素治疗妊娠期糖尿病,能降低患者血糖指标水平及血糖波动幅度,减轻胰岛素抵抗,改善血浆因子水平,减少分娩时不良母婴结局发生。Objective To study the clinical efficacy of metformin combined with norfloxacin on plasma factor and insulin resistance in patients with gestational diabetes mellitus.Methods A total of 96 patients with gestational diabetes mellitus admitted to the hospital from June 2017 to June 2019 were selected and divided into the observation group and control group according to random number table method,48 cases in each group.Both groups were given basic therapy such as health education,diet control and exercise training.The control group was given subcutaneous injection of norfloxacin,while the observation group was treated with metformin on this basis.Both groups were treated continuously until delivery.Results After treatment,the levels of fasting blood glucose(FBG),2 h postprandial blood glucose(2 h PG),glycated hemoglobin(HbA1 C),mean amplitude of plasma glucose(MAGE),standard deviation of blood glucos(SDBG),and absolute means of daily differences(MODD),homeostasis model assessment-insulin resistance(HOMA-IR)in the observation group were significantly lower than the control group(P<0.05),while the levels of plasma amylin(Amylin)and adiponectin(ADPN)were significantly higher than the control group(P<0.05);the incidence of adverse outcomes in the observation group,such as premature delivery,cesarean section,premature rupture of membranes,neonatal jaundice,respiratory distress,and neonatal asphyxia,was significantly lower than that in the control group(P<0.05);the incidence of adverse reactions in the observation group was 16.67%,which was comparable with 10.42%in the control group(P>0.05).Conclusion Metformin combined with norfloxacin has good effect in the treatment of gestational diabetes mellitus.It can reduce blood glucose index and mean amplitude of plasma glucose,reduce the insulin resistance,improve plasma factor level,and reduce adverse maternal and infant outcomes during childbirth.

关 键 词：妊娠期糖尿病 门冬胰岛素 二甲双胍 血糖指标 血浆因子 胰岛素抵抗 

分 类 号：R969.4[医药卫生—药理学] R977.15[医药卫生—药学]