扫描式葡萄糖监测系统在妊娠期血糖管理中的临床应用  

Research on the clinical application of flash glucose monitoring system in blood glucose management during pregnancy

作　　者：安妍[1] 祖菲 董雪洁 于萍 朱巍[1] AN Yan;ZU Fei;DONG Xuejie;YU Ping;ZHU Wei(Department of Endocrinology,Beijing Aerospace General Hospital,Beijing 100076,China;不详)

机构地区：[1]北京航天总医院内分泌科,北京100076 [2]中国人寿保险健康中心,北京100033

出　　处：《中华全科医学》2025年第3期365-368,共4页Chinese Journal of General Practice

基　　金：糖尿病防治研究北京市重点实验室开放基金项目(10025220109)。

摘　　要：目的针对接受胰岛素治疗的妊娠糖尿病(GDM)患者应用28 d扫描式葡萄糖监测(FGM)系统,观察FGM对患者血糖管理及妊娠结局的影响,为临床选择更优的血糖监测手段提供依据。方法研究对象为2022年4-10月北京航天总医院确诊GDM并接受胰岛素治疗的患者98例,按照随机数字表法分为FGM组(49例)和自我血糖监测(SMBG)组(49例),比较2组患者的空腹血糖(FBG)、餐后2小时血糖(2hPG)、平均血糖(MBG)、预估糖化血红蛋白(eHbA1c)、葡萄糖目标范围内时间(TIR)、低血糖发生率、体重达标情况及妊娠结局。结果FGM组MBG、eHbA1c水平显著低于SMBG组(P<0.05),2组FBG、2hPG、TIR差异无统计学意义(P>0.05)。FGM组患者孕期的体重达标情况明显高于SMBG组[61.22%(30/49)vs.40.82%(20/49),P<0.05]。FGM组孕妇剖宫产、早产、胎膜早破发生率、巨大儿发生率均显著低于SMBG组(P<0.05)。多因素logistic回归分析显示,孕期体重增长未达标(OR=14.639,95%CI:1.747~122.655,P=0.013)是不良妊娠结局(包括剖宫产和早产)的独立危险因素。结论应用FGM系统有助于GDM患者达到理想血糖控制及体重控制目标,降低不良妊娠结局的发生风险。Objective To apply the 28-day flash glucose monitoring(FGM)system to gestational diabetes mellitus(GDM)patients undergoing insulin therapy,observe the impact of FGM on blood glucose management and pregnancy outcomes,and provide evidence for the selection of better blood glucose monitoring methods in clinical practice.Methods The study subjects were 98 patients diagnosed with GDM and receiving insulin therapy at Beijing Aerospace General Hospital from April to October 2022.They were divided into the FGM group(49 cases)and the self-monitoring of blood glucose(SMBG)group(49 cases)using a random number table method.The fasting blood glucose(FBG),2-hour plasma glucose(2hPG),mean blood glucose(MBG),estimated glycated hemoglobin(eHbA1c),time to target blood glucose(TIR),incidence of hypoglycemia,weight compliance and pregnancy outcome were compared between the two groups.Results The levels of MBG and eHbA1c in FGM group were significantly lower than those in SMBG group(P<0.05),but there was no statistical significance in FBG,2hPG and TIR(P>0.05).The weight control rate during pregnancy in the FGM group was significantly higher than that in the SMBG group[61.22%(30/49)vs.40.82%(20/49),P<0.05].The incidence of cesarean section,premature birth,prelabor rupture of membranes,and macrosomia among pregnant women in the FGM group were significantly lower than those in the SMBG group(P<0.05).Logistic regression analysis revealed that underweight during pregnancy was an independent risk factor for adverse pregnancy outcomes,including cesarean section and preterm birth(OR=14.639,95%CI:1.747-122.655,P=0.013).Conclusion The application of FGM system can help achieve ideal blood glucose control and weight control,reducing the risk of adverse pregnancy outcomes.

关 键 词：妊娠糖尿病 扫描式葡萄糖监测 血糖管理 妊娠结局 

分 类 号：R714.256[医药卫生—妇产科学]