叶酸、维生素B6、甲钴铵联合门冬胰岛素治疗妊娠糖尿病合并高同型半胱氨酸血症患者的疗效观察

The Clinical Research of Combination of Folic acid,Vitamin B6,Methylcobalamin and Insulin aspart in Patients with Gestational Diabetes Mellitus and Hyperhomoeysteinemia

目的探讨叶酸、维生素B6、甲钴铵联合门冬胰岛素治疗妊娠糖尿病(GDM)合并高同型半胱氨酸血症(HHcy)患者的疗效及围生儿预后的影响。方法选择68例GDM合并HHcy孕妇,按随机抽样的方法随机分为治疗组和对照组。对照组34例在一般治疗基础上加用门冬胰岛素治疗,治疗组34例在对照组基础上给予维生素B610mg/d、叶酸5mg/d、甲钴铵500μg/d。结果治疗前后患者血糖、血浆Hcy浓度下降幅度治疗组明显高于对照组,差异有统计学意义(P<0.05)。围生儿结局:巨大儿、低血糖、低钙血症、高胆红素血症、红细胞增多症发生率治疗组明显低于对照组,差异有统计学意义(P<0.05)。结论叶酸、维生素B6、甲钴铵联合门冬胰岛素能够较好控制GDM合并HHcy患者血糖、降低血浆同型半胱氨酸水平,减少围产儿并发症,而且安全性好,值得临床推广应用。

Objective Investigate the treatment of gestational diabetes mellitus（GDM） of folic acid,vitamin B6,methycobal joint insulin aspart with hyperhomocysteinemia（HHcy） prognosis of patients the efficacy and perinatal children.Methods Select 68 cases of GDM merger HHcy pregnant women were randomly divided into a treatment group and a control group,according to the method of random sampling.The control group of 34 patients on the basis of the general treatment plus insulin aspart,Treatment group,34 patients on the basis of the control group plus vitamin B6 10 mg/d,folic acid 5 mg/d,methycobal 500μg/d.Results Blood glucose,plasma Hcy concentrations before and after treatment,to decline significantly higher in thez treatment group（P 0.05）.Perinatal child outcome：huge children,hypoglycemia,hypocalcemia,hyperbilirubinemia,polycythemia disease incidence of treatment group was significantly lower than the control group.The difference was statistically significant（P 0.05）.Conclusion Folic acid,vitamin B6,Methycobal joint aspart insulin to better control the GDM merger HHcy blood sugar,reduce plasma homocysteine levels,reduce perinatal complications,and the security is good,worthy of clinical application.