高压氧联合门冬胰岛素对妊娠期糖尿病孕妇胰岛素抵抗及妊娠结局的影响  

Effects of hyperbaric oxygen combined with insulin aspart on insulin resistance and pregnancy outcome in pregnant women with gestational diabetes mellitus

作　　者：杨坤[1] 郭云霞 刘艳会 王通奎 Yang Kun;Guo Yunxia;Liu Yanhui;Wang Tongkui(Department I of Obstetrics and Gynecology,The Second People’s Hospital of Liaocheng,Liaocheng 252600,China)

机构地区：[1]聊城市第二人民医院产一科,聊城252600

出　　处：《中华航海医学与高气压医学杂志》2024年第6期757-760,共4页Chinese Journal of Nautical Medicine and Hyperbaric Medicine

摘　　要：目的探讨高压氧联合门冬胰岛素对妊娠期糖尿病(GDM)孕妇胰岛素抵抗及妊娠结局的影响。方法回顾性分析2020年6月至2023年5月聊城市第二人民医院产一科收治的89例GDM孕妇的临床资料,按照随机数字法分为对照组(n=45例)和研究组(n=44例)。对照组孕妇予以皮下注射门冬胰岛素治疗,研究组在对照组治疗的基础上给予高压氧治疗。采用全自动生化分析仪测定治疗前后孕妇空腹血糖(FBG)、餐后2 h血糖(2hPBG);采用全自动糖化血红蛋白分析仪检测孕妇治疗前后糖化血红蛋白(HbAlc)水平。先采用荧光免疫法测定孕妇空腹胰岛素值(FINS),再运用稳态模型计算治疗前后孕妇胰岛素抵抗指数(HOMA-IR)。统计治疗后2组孕妇及新生儿不良结局。结果与治疗前比较,2组患者治疗后FBG、2hPBG及HbAlc水平均明显降低(P<0.01),且治疗后研究组均明显低于对照组(P<0.05或P<0.01)。与治疗前比较,2组患者治疗后HOMA-IR明显降低,且治疗后研究组明显低于对照组(P<0.01)。治疗后研究组孕妇妊娠期高血压、早产及羊水过多发生率明显低于对照组(P<0.05),研究组巨大儿、新生儿窒息发生率明显低于对照组(P<0.05)。结论高压氧联合门冬胰岛素治疗GDM具有较好的控糖效果,可明显改善孕妇胰岛素抵抗及妊娠结局。Objective To explore the effects of hyperbaric oxygen(HBO)combined with insulin aspart on insulin resistance and pregnancy outcome in pregnant women with gestational diabetes mellitus(GDM).Methods A retrospective analysis was conducted on the clinical data of 89 pregnant women with GDM admitted to the Department I of Obstetrics and Gynecology of the Second People’s Hospital of Liaocheng from June 2020 to May 2023.They were divided into a control group(n=45)and a treatment group(n=44),according to the random number table method.The pregnant women in the control group received subcutaneous injection of insulin aspart,while the treatment group received HBO therapy on the basis of the control group treatment.A fully automated biochemical analyzer was used to measure fasting blood glucose(FBG)and 2-hour postprandial blood glucose(2hPBG)before and after treatment;a fully automated glycosylated hemoglobin analyzer was employed to detect the level of glycosylated hemoglobin(HbAlc).The fasting insulin(FINS)was measured by fluorescence immunoassay,and Homeostasis Model Assessment-Insulin Resistance(HOMA-IR)before and after treatment was calculated by homeostasis model.Statistical analysis of adverse outcomes in two groups of pregnant women and newborns after treatment was performed.Results Compared with before treatment,FBG,2hPBG,and HbAlc were remarkably reduced in both groups of patients after treatment(P<0.01),and the indicators above in treatment group were significantly lower than those in the control group after treatment(P<0.05 or P<0.01).Compared with before treatment,the HOMA-IR of both groups of patients decreased significantly after treatment,and the HOMA-IR of the treatment group was dramatically lower than that of the control group after treatment(P<0.01).After treatment,the incidences of gestational hypertension,premature birth,and polyhydramnios in the treatment group were significantly lower than those in the control group(P<0.05),and the incidences of macrosomia and neonatal asphyxia in the treatment gro

关 键 词：妊娠期糖尿病 高压氧 门冬胰岛素 胰岛素抵抗 妊娠结局 

分 类 号：R714.256[医药卫生—妇产科学]