[1]蔡 玲.不同胰岛素给药模式对高龄妊娠期糖尿病患者血糖控制及母婴结局的影响[J].医学信息,2020,33(04):141-143.[doi:10.3969/j.issn.1006-1959.2020.04.045]
　CAI Ling.Effects of Different Insulin Administration Modes on Blood Glucose Control andMaternal and nfant Outcomes in Elderly Gestational Diabetes Mellitus Patients[J].Medical Information,2020,33(04):141-143.[doi:10.3969/j.issn.1006-1959.2020.04.045]
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不同胰岛素给药模式对高龄妊娠期糖尿病患者血糖控制及母婴结局的影响()

医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
33卷
期数:
2020年04期
页码:
141-143
栏目:
药物与临床
出版日期:
2020-02-15

文章信息/Info

Title:
Effects of Different Insulin Administration Modes on Blood Glucose Control andMaternal and nfant Outcomes in Elderly Gestational Diabetes Mellitus Patients
文章编号:
1006-1959（2020）04-0141-03
作者:
蔡 玲
（襄州区人民医院产科，湖北 襄阳 441000）
Author(s):
CAI Ling
(Department of Obstetrics,Xiangzhou District People’s Hospital,Xiangyang 441000,Hubei,China)
关键词:
胰岛素; 多次皮下给药; 胰岛素泵; 妊娠期糖尿病; 血糖; 母婴结局
Keywords:
Insulin; Multiple subcutaneous administration; Insulin pump; Gestational diabetes mellitus; Blood glucose; Maternal and infant outcomes
分类号:
R714.25
DOI:
10.3969/j.issn.1006-1959.2020.04.045
文献标志码:
A
摘要:
目的 比较胰岛素泵持续皮下注射与多次皮下注射两种胰岛素给药模式对高龄妊娠期糖尿病（GDM）患者血糖控制及母婴结局的影响。方法 选取2017年1月~2018年6月襄州区人民医院收治的高龄GDM患者100例作为研究对象，按照随机数字表法分为对照组和观察组，每组50例。两组均予以胰岛素治疗，对照组采用多次皮下注射的给药模式，观察组采用胰岛素泵持续皮下注射的给药模式，比较两组血糖控制情况[空腹血糖（FPG）、餐后 2h 血糖（2h PG）、糖化血红蛋白（HbA1c）]、治疗前后血清同型半胱氨酸（Hcy）及胱抑素C（Cys-C）水平变化及母婴结局。结果 观察组血糖达标时间短于对照组，胰岛素用量少于对照组，差异有统计学意义（P＜0.05）。治疗后，两组FPG、2h PG、HbA1c、Hcy、Cys-C低于治疗前，且观察组低于对照组，差异有统计学意义（P＜0.05）。观察组妊娠期高血压、低血糖、早产、羊水过多及新生儿窒息发生率低于对照组，差异有统计学意义（P＜0.05）；两组死胎、巨大儿、胎儿生长受限、畸形发生率比较，差异无统计学意义（P＞0.05）。结论 相比于多次皮下注射模式，胰岛素泵持续皮下注射的胰岛素给药模式能够有效提高血糖控制效果，降低血清Hcy、Cys-C水平，改善母婴结局。
Abstract:
Objective To compare the effects of continuous subcutaneous injection and multiple subcutaneous injections of insulin pump on insulin glucose control and maternal and infant outcomes in elderly patients with gestational diabetes mellitus (GDM).Methods A total of 100 elderly patients with GDM who were treated in Xiangzhou District People’s Hospital from January 2017 to June 2018 were selected as research objects. They were divided into control group and observation group according to the random number table method, with 50 cases in each group. The two groups were treated with insulin. The control group used multiple subcutaneous injections. The observation group used an insulin pump for continuous subcutaneous injections. The two groups were compared for blood glucose control[fasting plasma glucose(FPG),2h postprandial glucose(2h PG),glycosylated hemoglobin(HbA1c)], serum homocysteine (Hcy) and cystatin C (Cys-C) levels and maternal and child outcomes.Results The blood glucose of the observation group was shorter than that of the control group, and the amount of insulin was less than that of the control group,the difference was statistically significant(P<0.05). After treatment, FPG,2h PG, HbA1c, Hcy, and Cys-C were lower in the two groups than before treatment, and the observation group was lower than the control group,the difference was statistically significant (P<0.05).The observation group had lower rates of hypertension, hypoglycemia, preterm birth, polyhydramnios, and neonatal asphyxia in the observation group than the control group,the differences were statistically significant(P<0.05).There was no statistically significant difference in the incidence of stillbirth, gigantic infants, fetal growth restriction, and malformations between the two groups(P>0.05).Conclusion Compared with the multiple subcutaneous injection mode, the continuous subcutaneous injection of insulin pump by the insulin pump can effectively improve blood glucose control, reduce serum Hcy, Cys-C levels, and improve maternal and infant outcomes.

参考文献/References:

[1]李利平,姜宏卫,陈治珉,等.国际糖尿病妊娠研究组新诊断标准调查妊娠期糖尿病患病率及其危险因素分析[J].中国糖尿病杂志,2015,23(4):289-292. [2]景小凡,柳园,饶志勇,等.妊娠期糖尿病对母婴结局的影响分析[J].华西医学,2016,31(2):301-305. [3]胡昭怡.门冬胰岛素和生物合成人胰岛素治疗妊娠期糖尿病的临床疗效观察[J].中国妇幼保健,2015,30(15):2331-2332. [4]Valizadeh M,Alavi N,Mazloomzadeh S,et al.The Risk Factors and Incidence of Type 2 Diabetes Mellitus and Metabolic Syndrome in Women With Previous Gestational Diabetes[J].International Journal of Endocrinology and Metabolism,2015,13(2):e21696. [5]杨慧霞.妊娠合并糖尿病诊治指南(2014)(二)[J].中华妇产科杂志,2014,8(8):489-498. [6]李松,丛林,袁静,等.TLR4乙酰化对LPS-TLR4-NF-κB通路的影响及其在妊娠期糖尿病发病机制中的作用[J].安徽医科大学学报,2016,51(1):26-30. [7]喻晓燕.妊娠期糖尿病患者血糖控制效果对妊娠结局的影响[J].中国妇幼保健,2017,32(7):1426-1429. [8]史春虹,季阳阳,白然,等.实时动态胰岛素泵与“双C”方案对血糖控制不佳的2型糖尿病患者的疗效对比[J].中华医学杂志,2015,95(24):1930-1933. [9]罗钰铭.胰岛素泵与多次皮下注射治疗妊娠期糖尿病的疗效比较及对妊娠结局的影响[J].中国妇幼保健,2017,32(19):4857-4860. [10]贾晓炜,栾进.胰岛素两种给药方式对妊娠糖尿病疗效的比较[J].武警医学,2017,28(5):483-486. [11]康省,苏珂,龙艳,等.妊娠糖尿病患者血同型半胱氨酸与胰岛素抵抗、胱抑素C及叶酸水平的相关性[J].广东医学,2014,35(10):1558-1560. [12]李利娟.门冬胰岛素联合参芪地黄降糖颗粒治疗妊娠期糖尿病的效果及对血清Hcy、Cys-C的影响分析[J].中国妇幼保健,2017,32(14):3159-3161. [13]孙建利,陈利美.妊娠期糖尿病血糖控制水平对母婴结局的影响分析[J].实用预防医学,2015,22(5):576-578.

更新日期/Last Update: 2020-02-15