二甲双胍联合胰岛素干预对妊娠期糖尿病患者妊娠结局的影响  

Effects of metformin combined with insulin intervention mode on gestational diabetes mellitus patients

作　　者：柳杨 赵明沂[1] LIU Yang;ZHAO Mingyi(School of Pharmacy,Shenyang Pharmaceuical University Shenyang 110016,China;Department of Pharmacy,General Hospital of Northern Theater Connmand,Shenyang 110016,China)

机构地区：[1]沈阳药科大学生命科学与生物制药学院,辽宁沈阳110016 [2]北部战区总医院药剂科,辽宁沈阳110016

出　　处：《沈阳药科大学学报》2021年第2期192-196,共5页Journal of Shenyang Pharmaceutical University

摘　　要：目的观察探讨二甲双胍联合"三短一长"胰岛素干预模式治疗妊娠期糖尿病(gestationaldiabetes mellitus,GDM)的效果及其对血清晚期糖基化终产物(advanced glycation endproducts,AGEs)、谷胱甘肽过氧化物酶(Glutathione peroxidase,GSH-Px)、血管细胞黏附分子-1(vascular cell adhesion molecule-1,VCMA-1)水平和妊娠结局的影响。方法 70例GDM患者依据随机数字表法分为对照组和观察组,每组35例,对照组采用采用"三短一长"胰岛素干预模式治疗,观察组在此基础上加服二甲双胍,对比两组疗效及血清AGEs、GSH-PX、VCAM-1水平和妊娠结局差异。结果两组治疗后餐后2h血糖、空腹血糖、糖化血红蛋白较治疗前降低(P<0.05),组间比较差异具有统计学意义(P<0.05);两组治疗后治疗前血清AGEs、GSH-PX、VCAM-1水平差异无统计学意义(P>0.05),治疗后AGEs、VCAM-1降低(P<0.05),GSH-PX升高(P<0.05),组间比较差异具有统计学意义(P<0.05);观察组羊水过多、先兆子痫、产后出血、胎儿窘迫、新生儿低血糖和早产发生率低于对照组(P<0.05)。结论二甲双胍联合"三短一长"胰岛素干预模式治疗GDM的临床效果显著,可有效控制血糖水平,改善妊娠结局,可能与其减轻氧化应激和血管内皮损伤、改善胰岛素抵抗有关。Objective To explore the effects of metformin combined with "Three short and one long" insulin intervention mode on gestational diabetes mellitus patients and effects on serum AGEs,GSH-PX,VCAM-1 levels and pregnancy outcomes.Methods 70 patients with GDM were divided into the control group and the observation group according to the random number table method,35 cases in each group.The control group was treated with the "Three short and one long" insulin intervention mode.The observation group was given metformin on the basis of this group.Efficacy and serum AGEs,GSH-PX,VCAM-1 levels and differences in pregnancy outcomes.Results 2 hPG,fasting blood glucose and glycosylated hemoglobin after treatment were lower than before(P<0.05),and the difference between the two groups was statistically significant(P<0.05).There were no significant differences in serum AGEs,GSH-PX and VCAM-1 levels between the two groups(P>0.05).After treatment,AGEs and VCAM-1 decreased(P<0.05) and GSH-PX increased(P<0.05).The difference between the groups was statistically significant(P<0.05).The incidence of amniotic fluid,pre-eclampsia,postpartum hemorrhage,fetal distress,neonatal hypoglycemia and preterm birth in the observation group was lower than that in the control group(P<0.05).Conclusion The clinical effect of metformin combined with "three short one-in-one" insulin intervention mode in the treatment of GDM is effective,and can effectively control blood sugar levels,improve pregnancy outcome,which may be related to reducing oxidative stress and vascular endothelial damage,improving insulin resistance.

关 键 词：妊娠期糖尿病 二甲双胍 胰岛素 疗效 晚期糖基化终产物 谷胱甘肽过氧化物酶 血管细胞黏附分子-1 

分 类 号：R96[医药卫生—药理学]