大剂量维生素D联合胰岛素泵持续注射对妊娠期糖尿病患者血糖水平及妊娠结局的影响  

Effect of continuous injection of high-dose vitamin D and insulin pump on blood glucose level and pregnancy outcomes in patients with gestational diabetes mellitus

作　　者：丛晓庆 刘晓 赵娟 唐晓华 王晶莉 Cong Xiaoqing;Liu Xiao;Zhao Juan;Tang Xiaohua;Wang Jingli(Health Department,Rongcheng Maternal and Child Health Hospital,Rongcheng 264300,China;Department of Obstetrics,Rongcheng Maternal and Child Health Hospital,Rongcheng 264300,China;Department of Pre-marriage and Pre-pregnancy Examination,Rongcheng Maternal and Child Health Hospital,Rongcheng 264300,China)

机构地区：[1]荣成市妇幼保健院保健部,荣成264300 [2]荣成市妇幼保健院产科,荣成264300 [3]荣成市妇幼保健院婚-孕前检查科,荣成264300

出　　处：《国际医药卫生导报》2023年第4期501-505,共5页International Medicine and Health Guidance News

基　　金：山东省医药卫生科技发展计划项目(202005011317)。

摘　　要：目的探究大剂量维生素D联合胰岛素泵持续注射对妊娠期糖尿病患者血糖水平及妊娠结局的影响。方法选取2020年1月至2022年1月荣成市妇幼保健院接诊的102例妊娠期糖尿病患者进行随机对照试验。随机数字表法将其分为常规组和研究组,各51例。常规组年龄(35.25±5.26)岁;研究组年龄(36.25±6.54)岁。常规组小剂量维生素D联合胰岛素泵持续注射治疗。研究组大剂量维生素D联合胰岛素泵持续注射治疗。治疗2个月后,比较两组疗效、血糖水平[空腹血糖(FBG)、糖化血红蛋白(HbA1c)]、不良反应发生情况以及妊娠结局。采用χ^(2)检验和t检验。结果研究组总有效率高于常规组[92.16%(47/51)比74.51%(38/51),χ^(2)=5.718,P=0.017]。治疗前,两组HbA1c、FBG水平差异均无统计学意义(t=0.305、0.854,P=0.761、0.471)。治疗后,两组FBG、HbA1c水平均低于治疗前,且研究组FBG、HbA1c水平低于常规组(t=3.854、5.387,均P<0.001)。两组不良反应总发生率差异无统计学意义(χ^(2)=1.097,P=0.295)。随访至分娩,常规组新生儿窒息2例,早产儿5例,巨大儿2例;研究组早产儿1例,巨大儿1例;研究组术后不良妊娠结局发生率低于常规组[3.92%(2/51)比17.65%(9/51);χ^(2)=4.993,P=0.025]。结论大剂量维生素D联合胰岛素泵持续注射对妊娠期糖尿病患者效果显著,可降低血糖水平,改善妊娠结局,且安全。Objective To explore the effect of continuous injection of high-dose vitamin D combined with insulin pump on blood glucose level and pregnancy outcomes in patients with gestational diabetes.Methods From January 2020 to January 2022,102 patients with gestational diabetes treated at Rongcheng Maternal and Child Health Hospital were selected for the random control trial.They were divided into a routine group and a study group by the random number table method,with 51 cases in each group.The routine group were(35.25±5.26)years old.The study group were(36.25±6.54)years old.The routine group took low-dose vitamin D combined with continuous insulin pump injection therapy,and the study group high-dose vitamin D combined with continuous insulin pump injection therapy.After 2 months'treatment,the efficacies,blood glucose levels[fasting blood glucose(FBG)and glycosylated hemoglobin(HbA1c)],adverse reactions,and pregnancy outcomes were compared between these two groups.χ^(2) and t tests were applied.Results The total effective rate of the study group was higher than that of the routine group[92.16%(47/51)vs.74.51%(38/51);χ^(2)=5.718,P=0.017].Before the treatment,there were no statistical differences in HbA1c and FBG levels between the two groups(t=0.305 and 0.854,P=0.761 and 0.471).After the treatment,the levels of FBG and HbA1c in the two groups were lower than those before treatment;the levels of FBG and HbA1c in the study group were lower than those in the routine group(t=3.854 and 5.387,both P<0.001).There was no statistical difference in the total incidence of adverse reactions between the two groups(χ^(2)=1.097,P=0.295).Follow up to delivery,there were 2 cases of neonatal asphyxia,5 premature infants,and 2 giant infants in the routine group;there were 1 premature infant and 1 giant infant in the study group;the incidence of adverse pregnancy outcomes in the study group was lower than that in the routine group[3.92%(2/51)vs.17.65%(9/51);χ^(2)=4.993,P=0.025].Conclusion Continuous injection of high-dose vitamin D co

关 键 词：大剂量维生素D 胰岛素泵持续注射 妊娠期糖尿病 血糖水平 妊娠结局 

分 类 号：R714.256[医药卫生—妇产科学]