盐酸二甲双胍联合门冬胰岛素对妊娠期糖尿病患者妊娠结局及血清CysC、Hcy的影响  

Effect of Metformin Hydrochloride Combined with Menadione Insulin on Pregnancy Outcome and Serum CysC and Hcy in Patients with Gestational Diabetes Mellitus

作　　者：柴春晶 CHAI Chunjing(Department of Obstetrics and Gynecology,the Third Hospital of Heilongjiang Province,Bei´an,Heilongjiang Province,164000 China)

机构地区：[1]黑龙江省第三医院妇产科,黑龙江北安164000

出　　处：《糖尿病新世界》2022年第22期70-73,共4页Diabetes New World Magazine

摘　　要：目的探讨盐酸二甲双胍联合门冬胰岛素在妊娠期糖尿病(gestational diabetes mellitus,GDM)患者中的应用效果。方法选取2020年4月—2022年1月黑龙江省第三医院收治的96例GDM患者为研究对象,按随机数表法分为两组,各48例。对照组给予门冬胰岛素治疗,观察组在对照组基础上加用盐酸二甲双胍治疗,持续用药至患者分娩。对比两组临床疗效,血糖指标水平,胱抑素C(CysC)、同型半胱氨酸(Hcy)水平,血清学指标水平,妊娠结局及不良反应发生率。结果观察组治疗总有效率(95.83%)高于对照组(81.25%),差异有统计学意义(χ^(2)=5.031,P=0.025)。治疗后,观察组空腹血糖(FPG)(4.98±0.62)mmol/L、餐后2 h血糖(2 hPG)(6.33±0.90)mmol/L、糖化血红蛋白(HbA1c)(5.05±0.43)%低于对照组,差异有统计学意义(P<0.05)。治疗后,观察组总胆红素(TBIL)水平(13.03±1.22)μmol/L高于对照组(10.68±1.45)μmol/L,尿酸(UA)水平(208.36±8.77)μmol/L、尿微量蛋白(mAlb)水平(9.26±1.02)mg/L低于对照组(223.59±9.52)μmol/L、(10.62±1.49)mg/L,差异有统计学意义(P<0.05)。结论盐酸二甲双胍联合门冬胰岛素用于GDM患者治疗中,可增强疗效,改善血糖、CysC、Hcy水平,降低不良妊娠结局发生风险。Objective To investigate the effect of metformin hydrochloride combined with menadione insulin in patients with gestational diabetes mellitus(GDM).Methods 96 GDM patients admitted to the Third Hospital of Heilongjiang Province from April 2020 to January 2022 were selected as the research objects.They were divided into two groups according to the random number table,48 patients in each group.The control group was treated with aspartic insulin,and the observation group was treated with metformin hydrochloride on the basis of the control group,and continued to use the drug until delivery.The clinical efficacy,blood glucose index level,cystatin C(CysC),homocysteine(Hcy)level,serum index level,pregnancy outcome and adverse reaction rate of the two groups were compared.Results The total effective rate of treatment in the observation group(95.83%)was higher than that of the control group(81.25%),the difference was statistically significant(χ^(2)=5.031,P=0.025).Fasting plasma glucose(FPG)(4.98±0.62)mmol/L,2 h postprandial blood glucose(2 hPG)(6.33±0.90)mmol/L and glycated haemoglobin(HbA1c)(5.05±0.43)%in the observation group were lower than in the control group after treatment,the difference was statistically significant(P<0.05).After treatment,the total bilirubin(TBIL)level(13.03±1.22)μmol/L in the observation group was higher than in the control group(10.68±1.45)μmol/L,the uric acid(UA)level(208.36±8.77)μmol/L and urinary microprotein(mAlb)level(9.26±1.02)mg/L were lower than those in the control group(223.59±9.52)μmol/L,(10.62±1.49)mg/L,the difference was statistically significant(P<0.05).Conclusion Metformin hydrochloride combined with menadione insulin in the treatment of patients with GDM can enhance the efficacy,improve blood glucose,CysC and Hcy levels,and reduce the risk of adverse pregnancy outcomes.

关 键 词：妊娠期糖尿病 盐酸二甲双胍 门冬胰岛素 临床疗效 血糖指标 

分 类 号：R587.1[医药卫生—内分泌]