摘要目的 探讨不同胰岛素用药方式联合维生素D治疗妊娠期糖尿病（GDM）患者的临床效果及对妊娠结局的影响。方法 选取2017年1月～2020年1月广东祈福医院收治的60例GDM 患者作为研究对象。按照随机数字表法分为观察组（30例）和对照组（30例）。对照组患者实施分次皮下注射门冬胰岛素注射液联合维生素D滴剂治疗，观察组患者实施持续泵入门冬胰岛素注射液联合维生素D滴剂治疗。比较两组空腹血糖、餐后2 h 血糖、糖化血红蛋白水平、血糖达标时间、胰岛素用量、低血糖发生率及不良妊娠结局总发生率。结果 治疗后，两组患者空腹血糖、餐后2 h 血糖、糖化血红蛋白均低于治疗前，差异有统计学意义（P＜0.05）；治疗后，观察组空腹血糖、餐后2 h 血糖、糖化血红蛋白水平低于对照组，差异有统计学意义（P＜0.05）；观察组血糖达标时间、胰岛素用量低于对照组，差异有统计学意义（P＜0.05）；观察组不良妊娠结局总发生率和低血糖发生率低于对照组，差异有统计学意义（P＜0.05）。结论 胰岛素持续泵入给药联合维生素D治疗GDM 临床效果显著，有利于缩短血糖达标时间、减少胰岛素用量，并降低低血糖和不良妊娠结局的发生率。
Abstract：Objective To explore the clinical effect of different Insulin administration combined with Vitamin D on gestational diabetes mellitus (GDM) and its effect on pregnancy outcome.Methods A total of 60 patients with GDM who were admitted to Guangdong Clifford Hospital from January 2017 to January 2020 were selected as the study subjects.They were divided into observation group (30 cases) and control group (30 cases) according to the random number table method.The patients in the control group were treated by subcutaneous injection of Aspartic Insulin injection combined with Vitamin D drops,while the patients in the observation group were treated by continuous pump of Aspartic Insulin injection combined with Vitamin D drops.Fasting blood glucose,2 h postprandial blood glucose,glycosylated hemoglobin level,time of blood glucose reaching standard,insulin dosage,incidence of hypoglycemia and total incidence of adverse pregnancy outcomes were compared between the two groups.Results After treatment,fasting blood glucose,2 h postprandial blood glucose and glycosylated hemoglobin of patients in the two groups were lower than those before treatment,the differences were statistically significant (P＜0.05).After treatment,the levels of fasting blood glucose,2 h postprandial blood glucose and glycosylated hemoglobin in the observation group were lower than those in the control group,the differences were statistically significant (P＜0.05).The time of reaching the standard of blood glucose and the dosage of insulin in the observation group were lower than those in the control group,the differences were statistically significant (P＜0.05).The total incidence of adverse pregnancy outcomes and the incidence of hypoglycemia in the observation group were lower than those in the control group,the differences were statistically significant (P＜0.05).Conclusion Continuous pump Insulin combined with Vitamin D has a significant clinical effect in the treatment of GDM,which can shorten the time of reaching the standard of blood glucose,reduce the dosage of insulin,reduce the incidence of hypoglycemia and adverse pregnancy outcomes.
李诗韵 ;钟苑仪. 不同胰岛素用药方式联合维生素D治疗妊娠期糖尿病患者的临床效果及对妊娠结局的影响[J]. 中国当代医药, 2021, 28(6): 90-93.
LI Shi-yun; ZHONG Yuan-yi. The clinical effect of different Insulin administration combined with Vitamin D on gestational diabetes mellitus and its effect on pregnancy outcome. 中国当代医药, 2021, 28(6): 90-93.
Zhu Y，Mendola P，Albert PS，et al.Insulin-Like Growth Factor Axis and Gestational Diabetes Mellitus：A Longitudinal Study in a Multiracial Cohort[J].Diabetes，2016，65（11）：3495-3504.
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