早期胰岛素治疗对改善妊娠期糖尿病患者焦虑情绪及不良妊娠结局的价值分析  

The value of early insulin therapy in improving anxiety and bad pregnancy of gestational diabetes mellitus patients

作　　者：彭雪莲 Peng Xuelian(The Xiaogan Hospital of TCM,Xiaogan,Hubei 432000)

机构地区：[1]孝感市中医医院,湖北孝感432000

出　　处：《基层医学论坛》2023年第23期7-10,共4页The Medical Forum

摘　　要：目的 研究早期胰岛素治疗对改善妊娠期糖尿病(GDM)患者焦虑情绪及不良妊娠结局的价值。方法 选取2018年10月—2019年10月孝感市中医医院收治的110例GDM患者作为研究对象,按照接受胰岛素治疗时的孕周不同将其分为A组(<32周)和B组(≥32周),2组均给予诺和灵N皮下注射治疗,比较2组治疗前后血糖水平[空腹血糖(FPG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(HbA1c)]、胰岛素抵抗情况[胰岛素抵抗指数(HOMA-IR)、脂肪细胞因子(Chemerin)、视黄醇结合蛋白4(RBP4)]、焦虑状态[状态-特质焦虑问卷(STAI)],比较2组新生儿一般指标[总胆红素(TBIL)、pH值、体质量水平及1 min阿普加(Apgar)评分],另比较2组产妇不良妊娠结局发生情况。结果治疗后,A组FPG、2 h PG、HbA1c、HOMA-IR、Chemerin、R BP4水平及状态焦虑量表(S-AI)、特质焦虑量表(T-AI)评分显著低于B组(P<0.05)。2组新生儿TBIL、FPG、pH值、体质量水平及1 min Apgar评分差异无统计学意义(P>0.05)。A组不良妊娠结局总发生率16.36%,显著低于B组的34.55%(P<0.05)。结论 孕32周之前运用胰岛素治疗GDM有更好的血糖控制效果,利于改善患者胰岛素抵抗情况和不良妊娠结局,能减轻患者焦虑,安全性良好,临床价值较高。Objective To study the value of early insulin therapy in improving anxiety and adverse pregnancy in patients with gestational diabetes mellitus(GDM).Methods 110 GDMpatients admitted to our hospital fromOctober 2018 to October 2019 were selected as research objects.According to the different gestational weeks of insulin treatment,they were divided into group A(gestation<32 weeks)and group B(gestation≥32 weeks).Both groups were treated by hypodermic injection of Novolin N,the blood glucose levels(FPG,2 h PG,HbA1c),insulin resistance(HOMA-IR,Chemerin,RBP4)and anxiety state(STAI)before and after treatment were compared between the two groups.The general indexes of newborn(TBIL,pH value,body weight and Apgar score of 1 min)were compared between the two groups,and the adverse pregnancy outcomes of the two groups were compared.Results After treatment,FPG,2 h PG,HbA1c,HOMA-IR,chemorin,RBP4 and S-AI and T-AI scores in group A were significantly lower than those before and after treatment(P<0.05).There was no significant difference between the two groups in TBIL,FPG,pH value,body weight and Apgar score(P>0.05).The total incidence of pregnancy outcome in group Awas 16.36%,whichwas significantlylower than that in group B(34.55%)(P<0.05).Conclusion Before 32 weeks of gestation,using insulin to treat GDM has a better effect on blood glucose control,is conducive to improving insulin resistance and adverse pregnancy outcomes,and can reduce anxiety of patients,with good safety and high clinical value.

关 键 词：妊娠期糖尿病 早期胰岛素治疗 焦虑情绪 不良妊娠结局 

分 类 号：R714.256[医药卫生—妇产科学]