不同胰岛素给药方法对妊娠期糖尿病血糖控制的效果评价

Evaluation of the effect of different insulin administration methods on glucose control of gestational diabetes mellitus

目的探讨不同胰岛素给药方法对妊娠期糖尿病（GDM）血糖控制的效果。方法选取妊娠期糖尿病患者64例为研究对象，采用随机数字表法分为观察组和对照组，每组32例，观察组患者接受胰岛素泵持续皮下输注胰岛素治疗，对照组患者接受胰岛素多次皮下注射治疗，比较两组患者的血糖控制效果、焦虑（SAS）、抑郁（SDS）评分。结果治疗后4周时，观察组空腹血糖（FBG）、糖化血红蛋白（HbAlc）、餐后2h血糖（2hPG）含量均明显低于对照组[（5．89±0．66）mmol／L比（7．13±0．74）mmol／L，（7．14±0．82）％比（8．92±0．95）％，（8．87±0．92）mmol／L比（10．13±1．32）mmol／L；t=7．014、4．430、8．024，均P〈0．05]；观察组血糖波动幅度、胰岛素用量、低血糖发生率均明显低于对照组，血糖达标时间明显短于对照组[（5．64±0．65）mmol／L比（8．44士0．92）mmol／L，（0．52±0．06）U·kg^-1·d^-1比（0．73±0．09）U·kg^-1·d^-1。，6．25％比28．13％，（4．76±0．55）d比（7．41±0．94）d；X^2=14．061、10．983、5．379、13．764，均P〈0．05）]；焦虑自评量表（SAS）、抑郁自评量表（SDS）评分均明显低于对照组[（34．95±4．20）分比（40．23±3．98）分，（35．12±3．95）分比（38．36±3．88）分；t=5．162、3．310，均P〈0．05]。结论胰岛素泵持续皮下输注胰岛素治疗有助于控制血糖水平，减小血糖波动，缓解治疗过程中的负面情绪，是治疗GDM更为理想的胰岛素给药方法。

Objective To study the effect of different insulin administration methods on glucose control of gestational diabetes mellitus （GDM）. Methods Sixty - four cases with GDM were randomly divided into observation group and control group. The observation group received continuous subcutaneous insulin infusion insulin pump therapy, the control group received multiple subcutaneous insulin therapy. Then, the glucose control effect, SAS and SDS score were compared between two groups. Results After 4 weeks,the FBG, HbAlc, 2h PG of observation group were significantly lower than the control group[ （5.89±0.66 ） mmol/L vs （7.13±0.74 ） mmol/L, （ 7.14 ± 0.82） % vs （8.92 ±0.95）% ,（8.87 ±0.92）mmol/L vs （ 10. 13 ± 1.32） mmol/L] （t =7. 074,4. 430,8. 024, all P 〈0.05）. The glucose fluctuations, insulin amount, hypoglycemia incidence of the observati.on group were significantly lower than the control group,blood sugar standard time was shorter than the control group[ （5.64 ±0.65 ）mmol/L vs （8.44± 0.92）mmol/L,（0.52±0.06）U· kg^-1 · d^-1 vs （0.73 ±0.09）U · kg^-1· d^-1,6.25% vs 28.13%,（4. 76±0. 55） d vs （7.41 ± 0.94） d, t/X^2 = 14. 061,10. 983,5. 379,13. 764, all P 〈 0.05 ） ] ; SAS score, SDS score of the observation group were significantly lower than the control group [ （ 34.95 ± 4.2 ） points vs （ 40.23 ± 3.98 ） points, （35.12 ±3.95）points vs （38.36 ±3.88）points,t =5. 162,3. 310,all P 〈0.05） ]. Conclusion Continuous subcutaneous insulin infusion insulin pump therapy is helpful to control glucose levels, reduce blood sugar fluctuations and mitigate, negative sentiment during treatment,it is an ideal insulin administration method for the treatment of GDM.