二甲双胍联合地特胰岛素对妊娠期糖尿病患者肠道菌群的影响  

Effect of metformin combined with insulin detemir on intestinal flora in patients with gestational diabetes mellitus

作　　者：张杨[1] 罗玉萍 张元铭 成文俊[1] ZHANG Yang;LUO Yuping;ZHANG Yuanming;CHENG Wenjun(Department of Obstetrics,Luzhou People′s Hospital,Luzhou,Sichuan 646099,China)

机构地区：[1]四川省泸州市人民医院产科,四川泸州646099

出　　处：《公共卫生与预防医学》2025年第2期139-142,共4页Journal of Public Health and Preventive Medicine

摘　　要：目的探究二甲双胍联合地特胰岛素对妊娠期糖尿病(Gestational Diabetes Mellitus,GDM)患者肠道菌群的影响。方法选取2022年5月至2023年7月泸州市人民医院收治的176例GDM患者,按随机数表法分为单药组(地特胰岛素治疗)和联合组(二甲双胍联合特地胰岛素治疗),各88例。比较治疗前、分娩期两组的糖代谢水平、肠道菌群分布,统计两组母婴结局。结果分娩期,两组患者空腹血糖(FPG)、糖化血红蛋白(HbAlc)、最大血糖波动幅度(LAGE)及肠杆菌、肠球菌、大肠埃希菌含量均低于治疗前,联合组低于单药组(P均<0.05);两组双歧杆菌、乳酸杆菌含量升高,联合组高于单药组(P均<0.05);两组患者母婴不良结局无显著性差异(P>0.05)。结论二甲双胍联合地特胰岛素可有效降低GDM患者血糖水平,改善肠道菌群分布,且不增加母婴不良结局。Objective To explore the effect of metformin combined with insulin detemir on intestinal flora in patients with gestational diabetes mellitus(GDM).Methods A total of 176 patients with GDM admitted to Luzhou People′s Hospital from May 2022 to July 2023 were selected and randomly divided into a single drug group and a combined group,with 88 cases in each group.The single drug group was treated with insulin detemir,and the combined group was given metformin combined with insulin detemir.The glucose metabolism levels and intestinal flora distribution were compared between the two groups before treatment and during delivery.The maternal-infant outcomes were statistically analyzed and compared between the two groups.Results During delivery,the levels of fasting plasma glucose(FPG),glycosylated hemoglobin(HbAlc),and largest amplitude of glycemic excursions(LAGE),and the contents of Enterobacterium,Enterococcus and Escherichia coli in both groups were reduced compared with those before treatment,and the above indicators in the combined group were lower than those in the single drug group(all P<0.05).The contents of Bifidobacterium and Lactobacillus were increased in both groups,and the indicators were higher in the combined group than those in the single drug group(all P<0.05).There was no significant difference in adverse maternal-infant outcomes between the two groups(P>0.05).Conclusion Metformin combined with insulin detemir can effectively reduce blood glucose levels and improve intestinal flora distribution in patients with GDM,without increasing adverse maternal-infant outcomes.

关 键 词：妊娠期糖尿病 二甲双胍 地特胰岛素 糖代谢 肠道菌群 

分 类 号：R181[医药卫生—流行病学]