精蛋白重组人胰岛素联合门冬胰岛素治疗妊娠期糖尿病的疗效及其对血清和肽素水平、胰岛素抵抗和胰岛β细胞功能的影响  

Efficacy of recombinant human protamine insulin combined with insulin aspart in the treatment of gestational diabetes mellitus and its effect on serum copeptin level,insulin resistance and isletβcell function

作　　者：熊贤翠 贺译平 李亚妮 张昕彤 余凯 XIONG Xiancui;HE Yiping;LI Yani;ZHANG Xintong;YU Kai(The Second Department of Obstetrics,Northwest Women and Children′s Hospital,Xi′an,Shaanxi 710000,China)

机构地区：[1]西北妇女儿童医院产二科,陕西西安710000

出　　处：《检验医学与临床》2025年第5期596-599,604,共5页Laboratory Medicine and Clinic

基　　金：陕西省重点研发计划项目(2024SF-YBXM-233)。

摘　　要：目的探讨精蛋白重组人胰岛素联合门冬胰岛素治疗妊娠期糖尿病(GDM)的疗效及其对血清和肽素(Copeptin)水平、胰岛素抵抗和胰岛β细胞功能的影响。方法选取2021年3月至2023年1月该院收治的402例GDM患者作为研究对象,采用抽签的方法随机分为对照组和联合组,每组201例。对照组采用门冬胰岛素治疗,联合组采用门冬胰岛素联合精蛋白重组人胰岛素治疗。观察2组治疗前后血糖指标、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)、胰岛β细胞功能指数(HOMA-β)、血清Copeptin、同型半胱氨酸(Hcy)和胱抑素C(CysC)水平及不良反应。结果2组治疗后空腹血糖(FPG)、餐后2 h血糖(2 hPG)和糖化血红蛋白(HbA1c)水平均明显低于治疗前,且联合组治疗后FPG、2 hPG和HbA1c水平均低于对照组,差异均有统计学意义(P<0.05)。2组治疗后FINS水平均高于治疗前,HOMA-β均大于治疗前,HOMA-IR均小于治疗前,且联合组治疗后FINS水平高于对照组,HOMA-β大于对照组,HOMA-IR小于对照组,差异均有统计学意义(P<0.05)。2组治疗后血清Copeptin水平均高于治疗前,Hcy和CysC水平均低于治疗前,且联合组治疗后血清Copeptin水平高于对照组,Hcy和CysC水平均低于对照组,差异均有统计学意义(P<0.05)。2组不良反应总发生率比较,差异无统计学意义(P>0.05)。结论精蛋白重组人胰岛素联合门冬胰岛素治疗GDM患者对血糖指标、血清指标、胰岛β细胞功能改善更明显且安全。Objective To investigate the efficacy of recombinant human protamine insulin combined with insulin aspart in the treatment of gestational diabetes mellitus(GDM)and its effects on serum Copeptin level,insulin resistance and isletβcell function.Methods A total of 402 GDM patients admitted to the hospital from March 2021 to January 2023 were selected as the research objects,and they were randomly divided into control group and combined group by lottery method,with 201 cases in each group.The control group was treated with insulin aspartate,and the combination group was treated with insulin aspartate combined with protamine recombinant human insulin.The blood glucose index,fasting insulin(FINS),insulin resistance index(HOMA-IR),isletβcell function index(HOMA-β),serum Copeptin,homocysteine(Hcy)and cystatin C(CysC)levels and adverse reactions were observed before and after treatment in the two groups.Results The levels of fasting plasma glucose(FPG),2 h postprandial plasma glucose(2 h PG)and glycosylated hemoglobin(HbA1c)in the two groups after treatment were significantly lower than those before treatment,and the levels of FPG,2 h PG and HbA1c in the combined group after treatment were lower than those in the control group,and the differences were statistically significant(P<0.05).FINS levels in both groups were higher after treatment than before treatment,HOMA-βafter treatment were higher than that before treatment,HOMA-IR were lower than that before treatment in both groups,and HOMA-βafter treatment in the combined group was higher than that in the control group,FINS level in combined group was higher than those in control group,HOMA-IR was lower than that in the control group,the differences were statistically significant(P<0.05).After treatment,the level of serum Copeptin in the two groups was higher than that before treatment,and the levels of Hcy and CysC were lower than those before treatment,and the levels of serum Copeptin in the combined group were higher than those in the control group,and the levels o

关 键 词：妊娠期糖尿病 门冬胰岛素 精蛋白重组人胰岛素 和肽素 胰岛素抵抗 胰岛β细胞功能 

分 类 号：R714.25[医药卫生—妇产科学] R446.1[医药卫生—临床医学]