双歧杆菌三联活菌联合门冬胰岛素治疗GDM临床效果  

Clinical effect of the bifidobacterium triple viable bacteria combined with insulin aspart for treating pregnant women with gestational diabetes mellitus

作　　者：陈凯 梁微微 CHEN Kai;LIANG Weiwei(The First People's Hospital of Jiande City,Hangzhou,Zhejiang Province,311600;The Second Affiliated Hospital of Zhejiang University School of Medicine)

机构地区：[1]浙江省建德市第一人民医院,311600 [2]浙江大学医学院附属第二医院

出　　处：《中国计划生育学杂志》2025年第4期810-814,共5页Chinese Journal of Family Planning

摘　　要：目的:探讨双歧杆菌三联活菌联合门冬胰岛素治疗妊娠期糖尿病(GDM)效果。方法:随机数字表法将2022年6月-2023年2月建德市第一人民医院和浙江大学医学院附属第二医院就诊的200例GDM患者分为观察组和对照组各100例,对照组给予门冬胰岛素,观察组予以双歧杆菌三联活菌联合门冬胰岛素,两组均持续治疗至分娩。比较两组治疗前后肠道菌群、血清同型半胱氨酸(Hcy)、胱抑素C(Cys-C)、脂联素(APN)、糖脂代谢指标,不良反应及母婴结局。结果:治疗后观察组肠杆菌(8.06±0.54 CFU/g)、肠球菌(.04±0.75 CFU/g)低于对照组(8.85±0.60 CFU/g、7.78±0.61 CFU/g),乳杆菌(6.92±0.96 CFU/g)、双歧杆菌(8.10±0.86 CFU/g)均高于对照组(6.27±0.93 CFU/g、7.61±0.72 CFU/g),血清Hcy、Cys-C水平低于对照组,APN水平高于对照组,总胆固醇、甘油三酯、低密度脂蛋白胆固醇、空腹血糖、餐后2 h血糖、糖化血红蛋白均低于对照组,高密度脂蛋白胆固醇高于对照组,早产(3.0%)、产后感染(2.0%)、低出生体重儿(2.0%)发生率均低于对照组(13.0%、9.0%、11.0%)(均P<0.05),不良反应发生率(5.0%)与对照组(9.%)无差异(P>0.05)。结论:双歧杆菌三联活菌联合门冬胰岛素有助于改善GDM患者肠道菌群,调节血清Hcy、Cys-C、APN表达及糖脂代谢,降低不良母婴结局风险,安全有效。Objective:To investigate the efficacy of the bifidobacterium triple viable bacteria combined with insulin aspart for treating pregnant women with gestational diabetes mellitus(GDM).Methods:A total of 200 pregnant women with GDM who admitted to the hospital were selected and were randomly divided into observation group and control group(100 cases in each group)by random number table method from June 2022 to February 2023.The women in the control group received treatment of insulin aspart,while the women in the observation group received treatment of bifidobacterium triple viable bacteria combined with insulin aspart.The women in both groups were treated continuously until delivery.The intestinal flora,the levels of serum levels of homocysteine(Hcy),cystatin C(Cys-C),adiponectin(APN)and glucose and lipid metabolism indicators,the adverse reactions rate and the maternal and infant outcomes of the women were compared between the two groups.Results:After treatment,the levels of Enterobacteriaceae(8.06±0.54 CFU/g)and Enterococcus(.04±0.75 CFU/g)of the women in the observation group were significantly lower than those(8.85±0.60 CFU/g and 7.78±0.61 CFU/g)of the women in the control group.The levels of Lactobacillus(6.92±0.96 CFU/g)and Bifidobacterium(8.10±0.86 CFU/g)of the women in the observation group were significantly higher than those(6.27±0.93 CFU/g and 7.61±0.72 CFU/g)of the women in the control group.The levels of serum Hcy and Cys-C of the women in the observation group were significantly lower than those of the women in the control group,and the level of APN of the women in the observation group was significantly higher than that of the women in the control group.The levels of the total cholesterol,triglyceride,low-density lipoprotein cholesterol,fasting blood glucose,2-hour postprandial blood glucose and glycosylated hemoglobin of the women in the observation group were significantly lower than those of the women in the control group.The levels of the high-density lipoprotein cholesterol of the women i

关 键 词：妊娠期糖尿病 双歧杆菌三联活菌 门冬胰岛素 肠道菌群 糖脂代谢 母婴结局 

分 类 号：R714.256[医药卫生—妇产科学]