| 何文慧,刘风伟,秦业强,赵金梅,姚晓玲.门冬胰岛素、地特胰岛素、甘精胰岛素分别联合二甲双胍对糖尿病孕妇妊娠结局的影响[J].,2023,(23):4584-4589 |
| 门冬胰岛素、地特胰岛素、甘精胰岛素分别联合二甲双胍对糖尿病孕妇妊娠结局的影响 |
| Effect of Insulin Aspart, Insulin Detemir or Insulin Glargine Combined with Metformin on Pregnancy Outcomes in Pregnant Women with Diabetes Mellitus |
| 投稿时间：2023-05-21 修订日期：2023-06-17 |
| DOI：10.13241/j.cnki.pmb.2023.23.037 |
| 中文关键词: 门冬胰岛素 地特胰岛素 甘精胰岛素 二甲双胍 妊娠期糖尿病 |
| 英文关键词: Insulin aspart Insulin detemir Insulin glargine Metformin Gestational diabetes mellitus |
| 基金项目:河北省医学科学研究课题计划项目（20200291） |
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| 中文摘要: |
| 摘要 目的：探究门冬胰岛素、地特胰岛素、甘精胰岛素分别联合二甲双胍对糖尿病孕妇妊娠结局的影响。方法：随机抽取本院400例妊娠期糖尿病产妇为研究对象，按照简单随机法分为对照组（n=100例）、试验A组（n=100例）、试验B组（n=100例）和试验C组（n=100例）。对照组采用口服二甲双胍治疗，试验A、B、C组，分别采用门冬胰岛素、地特胰岛素、甘精胰岛素联合二甲双胍治疗。对比四组产妇的分娩方式，各产程时间，体重指数（BMI）、随机血糖、内脂素、脂联素的水平，妊娠并发症发生率，新生儿结局。结果：试验A、B、C组的自然分娩率均高于对照组（P<0.05），且试验A组的自然分娩率均高于试验B组、试验C组（P<0.05），试验B组、试验C组的自然分娩率对比无差异（P>0.05）；对照组、试验A、B、C组自然分娩产妇的第一产程、第二产程、第三产程时间对比无差异（P>0.05）；试验A、B、C组的BMI指数、随机血糖、内脂素、脂联素的水平均低于对照组（P<0.05），且试验A组的BMI指数、随机血糖、内脂素、脂联素的水平均低于试验B组、试验C组（P<0.05），试验B组、试验C组的BMI指数、随机血糖、内脂素、脂联素的水平对比无差异（P>0.05）；试验A、B、C组的妊娠并发症发生率均低于对照组（P<0.05），且试验A组的妊娠并发症发生率低于试验B组、试验C组（P<0.05），试验B组、试验C组的妊娠并发症发生率对比无差异（P>0.05）；试验A、B、C组的新生儿不良结局发生率均低于对照组（P<0.05），且试验A组的新生儿不良结局发生率低于试验B组、试验C组（P<0.05），试验B组、试验C组的新生儿不良结局发生率对比无差异（P>0.05）。结论：门冬胰岛素、地特胰岛素、甘精胰岛素分别联合二甲双胍均能够提高糖尿病孕妇妊娠的自然分娩率，降低BMI指数、随机血糖、内脂素、脂联素的水平，降低妊娠并发症发生率，改良新生儿不良结局，其中门冬胰岛素的疗效最好，具有较强的临床推广价值。 |
| 英文摘要: |
| ABSTRACT Objective: To explore the effect of insulin aspart, insulin detemir or insulin glargine combined with metformin on pregnancy outcomes in pregnant women with diabetes mellitus. Methods: 400 pregnant women with gestational diabetes mellitus were randomly collected as the study subjects and were divided into control group (n=100), trial group A (n=100), trial group B (n=100) and trial group C (n=100) according to simple randomization method. The control group was treated with oral metformin, and trial groups A, B and C were given insulin aspart, insulin detemir or insulin glargine combined with metformin respectively. The delivery mode, time of each stage of labor, body mass index (BMI), levels of random blood glucose, visfatin and adiponectin, incidence rates of pregnancy complications and neonatal outcomes were compared among the four groups. Results: The natural delivery rate in trial groups A, B and C was higher than that in control group (P<0.05), and the natural delivery rate in trail group A was higher than that in trial groups B and C (P<0.05), but there was no difference between trial group B and trial group C (P>0.05). There were no differences in the time of the first stage of labor, time of the second stage of labor and time of the third stage of labor among control group and trail groups A, B and C (P>0.05). The BMI, random blood glucose, visfatin and adiponectin in trial groups A, B and C were lower than those in control group (P<0.05), and the levels of BMI, random blood glucose, visfatin and adiponectin in trial group A were lower than those in trial groups B and C (P<0.05). There were no differences in BMI, random blood glucose, visfatin and adiponectin between trial group B and trial group C (P>0.05). The incidence rates of pregnancy complications were lower in trial groups A, B and C than those in control group (P<0.05), and were lower in trial group A than those in trial groups B and C (P<0.05), but there were no differences between trial group B and trial group C (P>0.05). The incidence rates of neonatal adverse outcomes in trial groups A, B and C were lower than those in control group (P<0.05), and the incidence rates of neonatal adverse outcomes in trial group A were lower than those in trial groups B and C (P<0.05), but there were no differences in the incidence rates of neonatal adverse outcomes between trial group B and trial group C (P>0.05). Conclusion: Insulin aspart, insulin detemir or insulin glargine combined with metformin can improve the natural delivery rate of pregnant women with diabetes mellitus, reduce the BMI, random blood glucose, visfatin and adiponectin, lower the incidence rates of pregnancy complications, and improve the neonatal adverse outcomes, and insulin aspart has the best efficacy and has strong clinical promotion value. |
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